HEALTH CARE REFORM FOR MICHIGAN’S MINORITY COMMUNITIES

1. HEALTH CARE REFORMFORMICHIGAN’SMINORITY COMMUNITIES Jean Chabut Deputy Director for Public Health Michigan Department of Community Health April 30, 2010

2. Impact on Michigan:Setting the Scene • Recession has hit Michigan long and hard – especially in our minority communities • Of the families at or above 200% Federal Poverty Level – 8.2% are uninsured • Of the families below 200% Federal Poverty Level – 22.2% are uninsured

3. Impact on Michigan:Setting the Scene • Michigan Black and Hispanic residents are nearly 2 times as likely as White residents to be uninsured (2007) • Black – 19% • Hispanic – 19% • White – 10.3%

4. Impact on Michigan:Setting the Scene • In Wayne County: • Poverty Rate – 20.5% • Child Poverty Rate – 29.3%

5. Impact on Michigan:Setting the Scene In our urban areas income levels are shocking: Source 2008 Five City Survey (Population-Based survey of African American adults in cities encompassing 80% of Afr-Amer. MI population)

6. Impact on Michigan:Setting the Scene Older Minorities (over age 45) are hit hard, too:

7. Impact on Michigan:Setting the Scene • Michigan couldn’t afford to do NOTHING: Michigan Families are SUFFERING • Insurance Premiums are SKYROCKETING • In 1997, family health insurance purchased through an employer cost $5,010 • In 2006, the same family health insurance cost $11,452 • By 2016, the same insurance is projected to cost $26,180, a 129% increase over 2006, which will consume 52.4% of projected Michigan median family income

8. Impact on Michigan:Setting the Scene • More People are UNINSURED • Every day, 620 Michiganders lose their health insurance • In 2007, 1,096,821 Michiganders under age 65 were uninsured for the entire year, which is 12.4% of the under 65 population

9. Impact on Michigan:Setting the Scene • Michigan Businesses SUFFER • In 2000, 54.2% of small businesses were able to offer health insurance coverage to their employees • In 2006, 40.9% of small businesses offered health benefits

10. Will Health Care ReformBe Good for Michigan Familiesand Minority Communities? Our Children • Prohibits health insurers from excluding coverage of children because of pre-existing conditions. • Extends Medicaid to people up to 133% Federal Poverty Level.

11. Will Health Care ReformBe Good for Michigan Familiesand Minority Communities? • Extends the Children’s Health Insurance Program (Mi-Child) and increases outreach and enrollment grants to help reach more eligible children. • Includes Oral and Vision Coverage for all children.

12. Will Health Care ReformBe Good for Michigan Familiesand Minority Communities? • Improve Quality of Care for Children: A recent study found that children receive recommended care less than half of the time. • Requires new plans to cover prevention and wellness benefits and exempts these benefits from deductibles and other cost-sharing requirements.

13. Will Health Care ReformBe Good for Michigan Familiesand Minority Communities? Our Families • Eliminates all lifetime limits on how much insurance companies cover if beneficiaries get sick. • Bans insurance companies from dropping people from coverage when they get sick. • This year, allows young adults to stay on their parents’ health care plan until age 26.

14. Will Health Care ReformBe Good for Michigan Familiesand Minority Communities? • Provides tax credits to working families to make sure they can afford quality coverage. • This year, provides tax credits to small businesses so they can offer competitive, affordable health care to their employees.

15. Will Health Care ReformBe Good for Michigan Familiesand Minority Communities? • Reduces cost-shifting that increases premiums for insured Americans, on average, about $1,000 a year. • Creates state-based health insurance Exchanges to provide families with the same private insurance choices that the President and Members of Congress will have.

16. Will Health Care ReformBe Good for Michigan Familiesand Minority Communities? • Going forward, the Act will prohibit insurance companies from denying coverage to all individuals. The Act will also end discrimination that charges beneficiaries more if they are sick.

17. Health Care ReformHelps Seniors, Too • This year, provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. • The Act will completely close the donut hole for all prescription drugs by 2020. • Not a penny of Medicare taxes or trust funds will be used for health reform.

18. Health Care ReformHelps Seniors, Too • Eliminates deductibles, co-payments, and other cost-sharing for preventive care, and provides free annual wellness check-ups starting in 2011. • Creates a voluntary long-term care insurance program, which will provide a cash benefit to help seniors and people with disabilities obtain services and supports that will enable them to remain in their homes and communities.

19. Other Benefits As Well • Invests in care innovations such as community health teams to improve the management of chronic disease. • Invests in the primary care workforce to ensure that all Americans have access to a primary care doctor so they stay healthier, longer.

20. Other Benefits As Well • Provides significant funding for community health centers to ensure high-quality, accessible care. • Moves toward elimination of disparities that minorities currently face both in the health and in their health care by investing in data collection and research about health disparities.

21. Prevention and Public Health Programs in Communities are Funded as well • Prevention and Public Health fund to provide for an expanded and sustained national investment in prevention and public health programs (over the FY 2008 level). • Funded at $500M in 2010 and growing to $2B in 2015 and thereafter.

22. Prevention and Public Health Programs in Communities are Funded as well • Prevention and Health Promotion Outreach and Education Campaign to provide for the planning and implementation of a national public private partnership for a prevention and health promotion campaign.

23. Prevention and Public Health Programs in Communities are Funded as well • Community Transformation Grants for CDC competitive grants to State and local governmental agencies and community-based organizations to reduce chronic disease rates, prevent the development of secondary conditions, and address health disparities.

24. Prevention and Public Health Programs in Communities are Funded as well • Provide $1.5 billion over five years to states, tribes, and territories to develop and implement one or more evidence-based Maternal, Infant, and Early Childhood Visitation models targeted at reducing infant and maternal mortality and its related causes.

25. Prevention and Public Health Programs in Communities are Funded as well • Provides $75 million per year through FY2014 for grants to States for programs to educate adolescents on both abstinence and contraception for prevention of teenage pregnancy and sexually transmitted infections, including HIV/AIDS.

26. Prevention and Public Health Programs in Communities are Funded as well • State Grants to Promote Community Health Teams that support the Patient-Centered Medical Home. Community-based interdisciplinary teams will provide support services to primary care practices, including OB/GYN practices.

27. Prevention and Public Health Programs in Communities are Funded as well • Creates a Community Health Center Fund that provides $11 billion in mandatory funding (over five years) for the Community Health Center program, the National Health Service Corps, and construction and renovation of community health centers.

28. Prevention and Public Health Programs in Communities are Funded as well • Authorizes $50 million over 4 years to establish a new grant program to support school-based health clinics that provide health services to children and adolescents.