Frontier and the Affordable Care Act

1. Introduction Frontier and the Affordable Care Act Frontier Partners Meeting – April 2013 Saskia van Hecke National Center for Frontier Communities

2. Background • June 2012 - ACA upheld by the Supreme Court, but… • States choose whether or not to expand Medicaid coverage. 25 states committed to expansion as of April 1st • Half of states opt for federally run insurance exchanges/marketplaces

3. ACA will bring many changes… • More people insured (Medicaid or private insurance) • Required core services • Shortage of primary care providers? • Larger role for Community Health Centers • How will all of this affect frontier communities?

4. Frontier-specific ACA provisions • Designation of “Frontier Health Professional Shortage Areas” • Designation of “Frontier States,” enhanced reimbursement for providers in these states (MT, NV, ND, SD, WY.Special provisions for AK) • Frontier data collection mandated • Frontier representation on National Health Care Workforce Commission mandated

5. Medicaid Expansion

6. Frontier and Medicaid Expansion

7. Insurance Marketplaces

8. Frontier and Insurance Marketplaces

9. ACA in States with highest % population in Frontier

10. Discussion Questions • How can frontier communities provide access to the range of services required under ACA? • What kind of infrastructure is necessary for frontier communities to meet ACA requirements and timelines? • Are there additional workforce needs to provide access to care in frontier areas? • What are the roles/expectations of community health centers to provide services to the newly insured?

11. How can frontier communities provide access to the range of services required under ACA?

12. What kind of infrastructure is necessary for frontier communities to meet ACA requirements and timelines for: • Insurance Exchanges • Insurance enrollment (including Medicaid) and • Enforcement?

13. Are there additional workforce needs to provide access to care in frontier areas?

14. What are the roles/expectations of community health centers to provide services to the newly insured?

16. Additional resources

17. List of required service areas under ACA • Ambulatory patient services; • Emergency services; • Hospitalization; • Maternity and newborn care; • Mental health and substance use disorder services; • Prescription drugs; • Rehabilitative and habilitative services and devices; • Laboratory services; • Preventive services and chronic disease management; • Pediatric services, including oral and vision care.