1. Illinois Maternal & Child Health Coalition Starting Strong for Community Health! The Affordable Care Act and Medicaid Expansion Kathy Chan, Illinois Maternal and Child Health Coalition Stephanie Altman, Health & Disability Advocates Jason Montrie, Land on Lincoln Health, Inc Tuesday, April 23, 2013 For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com Starting Strong for Community Health! Land of Lincoln Health: Illinois’ Consumer Operated and Oriented Plan

2. About IMCHC Our Projects and Initiatives: Campaign to Save Our Mothers and Babies Chicago Area Immunization Campaign Cooking Matters, a program of Share Our Strength’s No Kid Hungry Campaign Illinois Coalition for School Health Centers Illinois Premature Infant Health Network text4baby www.ilmaternal.org/ Healthcarereform Become a fan on Facebook! Follow us on Twitter at ILMaternal! Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com

3. Webinar Overview Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com New Non-Citizen uninsured data Learn more about Consumer Operated and Oriented Plans (CO-OPs) and how they differ from traditional private insurance plans; Hear from staff from Land of Lincoln Health, Inc. about coverage areas, benefits, and other plan details; Receive updates on ACA implementation efforts.

4. Non-Citizen Medicaid Eligibility Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com  Current Medicaid non-citizen eligibility restrictions are maintained in 2014 including the five year waiting period (the “five year bar”) for most lawfully residing low-income immigrant adults.  The Children’s Health Insurance Program allows lawfully residing children and pregnant women regardless of their date of entry (no five year bar) by state option.  Illinois’ All Kids program currently covers children with family income under 300% FPL, regardless of immigration status  Illinois’ Moms and Babies program covers pregnant women with family income below 200% FPL, regardless of immigration status

5. Non-Citizen Marketplace Eligibility Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com  Naturalized Citizens:  Same access and requirements as U.S. born citizens.  Lawfully Present:  IS Eligible to Purchase Insurance from the State Health Insurance Marketplace  IS eligible for premium tax credits  IS (or is reasonably expected) to be lawfully present during entire period of enrollment  IS subject to individual mandate.

6. 2010-11 Non-Citizen Data Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com  823,750 Non Citizens in Illinois.  430,141 (52%) are Uninsured  Total Non-Citizen Number includes:  Legal Permanent Residents (LPRs) (eligible and ineligible for Medicaid)  Lawfully Present  Undocumented  New version of Visualizing Health Reform (www.illinoishealthmatters.org) will have some citizenship datawww.illinoishealthmatters.org

7. Paths to Coverage for Non-Citizens in 2014 Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com  149,283 uninsured Legal Permanent Residents in Illinois  Those who have been in the US less than 5 years may not be eligible for Medicaid but could be eligible for premium tax credits in the marketplace in 2014.  280,858 uninsured undocumented persons in Illinois  No new path to coverage in 2014.

8. Outreach and Enrollment Issues Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com  Reaching non-citizens will be difficult for several reasons including limited English speakers; confusion on eligibility; mixed status families; fear of immigration issues.  Undocumented non-citizens will continue to need access through county hospitals; public health departments; free and charitable clinics; federally qualified health centers.  LPRs may experience disruption in coverage moving from marketplace to Medicaid after 5 years.

9. What is a CO-OP Plan? Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com Consumer Operated and Oriented Plan (CO-OP) – Increase competition among individual and small group plans – Improve consumer choice in this smaller market Key Characteristic: consumer run governance – Policy and direction of CO-Ops are set by a board of directors elected by a majority of membership (plan holders)

10. CO-OPs in ACA Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com CO-Ops will offer health coverage—and possibly care networks—through the Marketplaces under the same regulatory requirements imposed on private insurance companies at the state and federal level. CO-Ops will offer small group/individual coverage and must be ready for open enrollment beginning on October 1, 2013

11. CO-OPs: Key Features/Terms Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com Sponsors: “persons applying to become qualified nonprofit health insurance issuers” – Include consumer groups, community organizations, medical provider organizations, unions, business coalitions, and other stakeholder groups. – Sponsors must provide at least 40% of CO-OP funding Member governed and operate with strong consumer focus Must be a nonprofit corporation Must offer at least 2/3 of policies on Marketplace Must comply with state insurance laws and regulation

12. CO-Ops vs Private Insurance Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com CO-OPs are nonprofit corporations – All surplus revenue must be used to reduce premiums, improve benefits, or improve quality of care for its members Consumer run governance – The policy and direction of CO-Ops are set by a board of directors elected by a majority of the membership. – Allow consumers to have strong voice in their health insurance options Included in ACA to bring competition and choice to health insurance marketplaces

13. Land of Lincoln Health, Inc Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com Jason Montrie Vice President of Network and Channel Development Land of Lincoln Health, Inc www.landoflincolnhealth.org

14. Medicaid Expansion in Illinois In 98 th GA, SB26 (Sen. Steans) and HB106 (Rep. Feigenholtz)SB26HB106 SB26 passed the full Senate in February; now awaits House action Download a fact sheet with the list of supporters at: http://www.ilmaternal.org/docs/factsheets/MedicaidExpansionf actsheetwithsupporters1-15-13.pdf http://www.ilmaternal.org/docs/factsheets/MedicaidExpansionf actsheetwithsupporters1-15-13.pdf – Contact Kathy Chan at kchan@ilmaternal.org to add your organization’s namekchan@ilmaternal.org Make phone calls and send emails to your Representative! See how SB26 affects YOUR district: # of new eligibles per district available on www.illinoishealthmatters.orgwww.illinoishealthmatters.org Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com

15. Additional Pending Policy Decisions Establishment of a state-based competitive health insurance marketplace SB1194/HB2608 – “Bad” Navigator Bill – Fact sheet posted at http://ilmaternal.org/docs/factsheets/OPPOSE_SB1194- HB2608Factsheet_03-13-2013.pdf http://ilmaternal.org/docs/factsheets/OPPOSE_SB1194- HB2608Factsheet_03-13-2013.pdf – Contact Kathy Chan at kchan@ilmaternal.org to add your organization’s namekchan@ilmaternal.org Implementation of Medicaid reform legislation State budget challenges - ongoing need to preserve Medicaid and related programs Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com

16. Advocacy Opportunities Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com Governor’s Health Reform Implementation Council Meetings: www.healthcarereform.illinois.gov www.healthcarereform.illinois.gov Medicaid Advisory Council and subcommittees: http://www2.illinois.gov/hfs/PublicInvolvement/Boardsa ndCommisions/MAC/Pages/default.aspx http://www2.illinois.gov/hfs/PublicInvolvement/Boardsa ndCommisions/MAC/Pages/default.aspx

17. What You Can Do! Spread the word! Subscribe to IMCHC’s newsletter and action alert, Facebook, Twitter (@ILMaternal) Download and share our factsheets and toolkit Subscribe to our podcast Invite us to present and suggest future topics Bookmark www.illinoishealthmatters.orgwww.illinoishealthmatters.org Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com

18. IMCHC’s ACA Ambassadors Get paid to learn about health reform! Affordable Care Act (ACA) Ambassadors. ACA Ambassadors will serve as an extension of IMCHC as we work to help communities understand health reform and the impact on families, individuals, and businesses. – ACA Ambassadors should live in the Chicagoland area, including suburbs and collar counties ACA Ambassadors will receive a stipend of $600 if they successfully meet the established goals. Learn more and submit application online. Application deadline is May 10. http://www.ilmaternal.org/acaambassadors.html Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com

19. Next Webinar: May 21 Register now for the next Starting Strong Webinar on May 21 from 2-3pm Connecting Consumers to Coverage: Navigators, In Person Assistors, and Certified Application Counselors https://www3.gotomeeting.com/register/576702254 Illinois Maternal & Child Health Coalition For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com

20. Questions? Stephanie Altman saltman@hdadvocates.org www.hdadvocates.org www.illinoshealthmatters.org Illinois Maternal & Child Health Coalition Kathy Chan kchan@ilmaternal.org 312-491-8161x24 www.ilmaternal.org For webinar technical support, please call 800-263-6317 and press options 2, 1, 1 or visit http://support.gotomeeting.com

21. Resources Illinois Maternal & Child Health Coalition