Expanding Access to Health Care in Denver under the ACA Percent Uninsured Nearly 20% of Denver’s population, an estimated 104,000 residents, lack health insurance, and an even higher number lack dental insurance. Some of the benefits of insurance include: • Improved access to care and the ability to have a consistent care provider. • Increased use of preventive services, such as cancer screening. 50% Lack of Insurance in Denver • Protection from some of the financial risks related to 40% medical costs. 29% 26% 30% 23% 21% • Improved mental health. 20% Who lacks health insurance now? Denver’s uninsured are predominantly younger adults between 19 and 49 years of age. Other groups who are more likely to be uninsured include: • Men more than women. • Hispanics more than Whites, Blacks and other races. • Single people more than married, divorced or separated. • People who live in west and north Denver more than people in other parts of the city. 10% 0% 17% 14% 9% 14% 11% 13% 1% Source: 2011 American Community Survey New coverage opportunities in 2014 The Patient Protection and Affordable Care Act (ACA) is a historic opportunity to improve the health of Denver residents. It has already expanded health coverage for young adults by allowing them to stay on their parents’ plans until age 26, and eliminated denials of health insurance coverage for children with pre-existing conditions. In 2014 the ACA will also: • Significantly expand eligibility for Medicaid to be strictly income-based. • Provide governmental assistance for many people to purchase health insurance through Colorado’s new health insurance exchange, Connect for Health Colorado. • Eliminate denials of health insurance coverage for all persons with pre-existing conditions. Denver Residents Eligible for New Coverage in 2014 How many Denver residents will qualify? • More than 75,000 Denver residents, or 72% of the uninsured population, are expected to qualify for either Medicaid or subsidized insurance through the Exchange. • Another 7% will be required to purchase insurance without governmental support, but should be able to do so for less on the Exchange. • Undocumented persons will not be eligible for expanded coverage under Medicaid or the Exchange. Source: 2011 American Community Survey Window of Opportunity for Access to Care in 2014 The ACA offers an unprecedented opportunity to increase access to care for Denver residents and to change our health care delivery system from a high-cost, episodic, “sick care” system to a more comprehensive, preventive health care system that integrates primary care, behavioral health care, and substance abuse treatment. The ACA contains many provisions for promoting prevention and wellness, protecting consumers, improving health care quality and system performance, and curbing rising health costs. Despite these enormous opportunities, several factors could inhibit the expansion of coverage: • Lack of knowledge about the ACA. A recent Kaiser Family Foundation poll found that 42% of Americans did not know that the ACA was law. • Reluctance to enroll in governmental programs or to purchase insurance through the Exchange, despite the subsidies offered, and given the small penalty in 2015 for failing to purchase health insurance. • Confusion resulting from the large number of insurance plans (150) offered on the Exchange. Free Preventive Services Under ACA Pregnancy Pediatrics Sexual Health Infections Mental Health Cardiovascular Disease Screening for anemia & infections; vitamins Cancer Screening for breast, cervical, & colon cancer Tobacco Screening & cessation services Hearing & vision screening; vaccinations STD screening & prevention Hepatitis C & HIV testing; adult vaccinations Depression screening Screening for high blood pressure, diabetes, high cholesterol, & obesity Potential Benefits of ACA in CO • • • • • • Lower cost to taxpayers for uncompensated care. Mitigation of extra costs paid by the insured to cover uncompensated care. 6-17% reduction in growth of health care costs. 10-25% reduction in premiums for employersponsored insurance. 19,000 new jobs. 1% increase in economic output due to freed up resources, job creation, increased worker productivity. Source: The Colorado Trust (2011), Issue Brief: The Economic Impact of Health Reform in Colorado. What Can You Do to Increase Access to Care in Denver? • • • Advocate with family, friends, and colleagues about the benefits of health insurance and the new opportunities for coverage under the ACA in 2014. Provide information about the ACA and the new types of coverage to friends, family, clients, patients, staff and visitors to your organization. Help people get signed up. Direct them to online sites and in-person enrollment assistance sites to check their eligibility for Medicaid and subsidized insurance through the Exchange, and to sign up. Medicaid When to Apply: Starting October 1, 2013 Deadline: None Coverage Starts: January 1, 2014 Who is Eligible: Up to 133% FPL $15,282/year - single $32,322/year - family of four Phone: Toll-free: 1-800-221-3943 TDD: 1-800-659-2656 Apply Online: Colorado.gov/PEAK Apply in Person: Lists of sites available at: colorado.gov/apps/maps/hcpf.map Connect for Health Colorado When to Apply: Deadline: Coverage Starts: Who is Eligible: Starting October 1, 2013 March 31, 2014 January 1, 2014 133-400% FPL for subsidy $45,900/year – single $94,200/year – family of four If not covered by employer If not eligible for Medicare Phone: Toll-free: 1-855-PLANS4YOU Toll-free: 1-855-752-6749 Apply Online: ConnectforHealthCO.com Apply in Person: List of sites available at: connectforhealthco.com/let-us-help/assistance-network/