1. The Patient Protection and Affordable Care Act Young Adult Outreach and Education

2. Who are Young Invincibles?

3.  How does the ACA affect young adults  Young adult outreach Overview

4. How many people in Texas lack health insurance? Texas currently has the highest uninsured population of any state in the country

5. Uninsured Young Adults in Texas  Currently over 2.5 million uninsured 18-35 year olds  38% of young people are uninsured

6. What Parts of the ACA Affect Young Adults?

7.  Under 26 can stay on parent’s plan  Under 19 – no denial for pre- existing conditions  Free Preventive Care – no co-pays on screenings and check-ups Wins for Young Adults

8.  Previously unregulated  Now subject to standardized ACA requirements  Must include certain benefits  80/20 Ratio Student Health Plans

9. Women’s Health  Well-women visits  Support for breastfeeding  Domestic violence screening and counseling  Mammograms and cancer screenings

10. Contraception  As of Aug 2012, new health insurance plans must cover contraception with no co-pay  Religiously-affiliated institutions get 1 year delay  After Aug. 2013, employees and students get coverage directly from insurance companies  Religious institutions exempt

11. What Changes Will Come in 2014?

12.  Medicaid Expansion  Subsidies  Exchanges/Marketplaces  Growth of CHCs  Individual Mandate Changes to Come

13.  Currently eligible:  Low-income children and pregnant women  Working parents only if income = or <26% of FPL  Eligible in 2014:  EVERYONE <133% of FPL  States can decide whether to expand  Gov. Perry opposed, state legislature will decide  1.5 million young adults Texas and Medicaid

14.  Those making 133-400% of the federal poverty level (FPL) will qualify for subsidies (tax credits) to buy insurance on the exchange  133% of FPL for 1 person is $14,900  44% of FPL for 1 person is $44,000 Subsidies/Tax Credits

15. How Much of a Subsidy? FPLIncomePremiumTax CreditActual Cost 133%$1,238$282$243$40 250%$2,327$282$101$181 Subsidies based on Silver healthcare plan. Individuals can receive subsidy but apply to Bronze plan to save money.

16.  Can shop for insurance  Each state is different, some will have federally- facilitated exchanges (FFEs)  Subsidies applied directly Ex-cha-cha-cha-Changes

17. Exchanges in the States  In July 2012, Governor Rick Perry informed HHS that Texas will not create a state exchange program  TX, AK, LA, FL, SC, NH, and ME will have a federally-facilitated exchange programs Picture Source: Center on Budget and Policy Priorities

18.  Currently 7,000 CHCs provide care to 20 million individuals  Collectively financed at $2.2 billion  Provisions in ACA expected to finance 14,000 CHCs at $11 billion, doubling patient population Growth of Community Health Centers (CHCs)

19.  No Annual Limits  Tax Credit for employers  Catastrophic plans  Marketed to the young  Targets those with financial hardship Other important parts of the ACA Picture Source: http://wymancenter.org/the-importance-of-bulking-up-the-muscle-of-perseverance/

20.  Individuals must have qualifying health insurance  If not, penalties  $95 the first year  Rises by 2016  Exemptions Individual Mandate and Penalties Picture Source: http://thepinkleague.com/2012/08/30/so-whats-the-lowdown-the-basics-of-football-part-2/

21. Jessica, 19 years old  Part-time student, part-time job  $10,000/year before taxes ~ 90% of poverty  Without Medicaid expansion, she doesn’t qualify for Medicaid and would not have health insurance

22. Jeff, 21 years old  Part-time student, full-time construction worker  Earns $23,000/year  Takes home: $1,580/month  Total health premium: $282/month  With tax credits he pays: $120/month

23. Outreach and Education for Young Adults in Texas

24.  Health Care Outreach  Mobile Technology  Social Media  Challenges  Navigators  Timeline Overview

25.  Traditional Outreach  Tabling  Group Presentations  Hosting events  New Outreach Strategies Health Care Outreach

26.  Your Healthcare Finder  Find doctors in the area  For Android and iPhoneAndroidiPhone  Mobile Website  Text Message Services  QR Codes  Can be scanned and direct users to your website Mobile Outreach

27.  Facebook  Create events  Send news updates  Twitter  Connect with new people  Coordinate plans  Retweet  Be fun! Using Social Media Picture Source: Wikimedia Commons

28.  It’s expensive  ACA offers new options  I’m young and healthy  Injuries can happen to anyone  Make it personal  I don’t believe in health insurance  Uninsured drives up health care costs  Individual mandate requires insurance Why do I need Insurance?

29.  State exchanges – formal “Navigator” program  States with federal exchanges – likely assistance on outreach Navigators & Assisters

30.  Present – end of 2012:  Educate young adults about ACA  Ensure young adults are on dependent coverage  Jan 2013 – Oct 2013:  Educate young adults about the upcoming Exchanges.  Oct 1 st, 2013 – March 31 st, 2014  Open enrollment for exchanges  Ensure young adults are getting subsidies and Medicaid, if possible Timeline: What to Look For

31.  ACA is phasing in, some changes already underway  Many uninsured young adults in Texas  Outreach and education  Traditional outreach  Social media and mobile technology  Big changes in 2013 Key Takeaways