Engaging AAPIs in Ohio

1. Engaging AAPIs in Ohio The Ohio Health Insurance Exchange & SHOP

2. The Ohio Health Insurance Exchange & SHOP • Problems in health care today for AAPIs • What are the Exchange & SHOP*? • Benefits of an Exchange & SHOP for AAPIs • Making the Exchange & SHOP Work for AAPIs • *Small Business Health Options Program

3. Problems in Health Care Today for AAPIs • Vulnerable AAPIs ‘slip through the cracks’ of the health care system due to: • Lack of insurance • Underinsurance • Health disparities

4. What are the Exchange & SHOP? • The Exchange & SHOP will be “insurance supermarkets” for individuals and small businesses, respectively. • They will have an easy-to-use website for comparison shopping of multiple health plans. • The PPACA calls on each state to establish an Exchange & SHOP by 2014.

5. Benefits of an Exchange & SHOP • If designed and operated ideally, the Exchange & SHOP would offer AAPIs greater and fairer access to health insurance through: • Affordability • Transparency • Quality • An Essential Health Benefits package in every plan sold in the Exchange/SHOP (Qualified Health Plan) • Consumer advocacy and guidance • Navigators from the communities they serve.

6. Benefits of an Exchange & SHOPAffordability • Lower premiums, higher discounts Bargaining power of many individuals and small businesses • Exchange & SHOP will also monitor premium increases

7. Benefits of an Exchange & SHOPAffordability • Tax credits to help buy insurancefor middle-class consumers [family of 4 earning up to $90,000 in 2011] • Co-pay & deductible assistance for eligible consumers. • Although unlikely to be eligible for Medicaid, legal permanent residents will qualify for tax credits to buy insurance in the Exchange • Would especially benefit low-income AAPI groups (Southeast Asians & NHPIs) • Tax credits for small employers to help buy insurance • Increase from 35% to 50% of insurance costs in 2014 • The majority of AAPI-owned firms will qualify due to low numbers of employees

8. Benefits of an Exchange & SHOPTransparency • Easy comparison of health plans for consumers • Easy-to-understand, standardized language describing costs and benefits of all Qualified Health Plans (QHPs) • Easy-to-use website built for comparison shopping

9. Benefits of an Exchange & SHOPQuality • Essential Health Benefits package: every QHP sold in the Exchange/SHOP, regardless of price, will cover a standard set of benefits from 10 benefit categories. • rehabilitative and habilitative services and devices • laboratory services • preventive and wellness services and chronic disease management* • pediatric services, including oral and vision care. • ambulatory patient services • emergency services • hospitalization • maternity and newborn care • mental health and substance use disorder services* • prescription drugs

10. Benefits of an Exchange & SHOPConsumer Advocacy & Guidance • The Exchange/SHOP will regulate participating insurers • Prohibit unethical advertising • Monitor and review premium increases • Designated or certified “Navigators” • Non-profit, third-party organizations • Help consumers find, understand and enroll in the Exchange health plan which best suits their needs

11. Exchange & Shop Making it Work for AAPIs • To maximally empower AAPIs, and all health care consumers, the Exchange & SHOP should be designed and operated along these principles: • Run by Ohio • Pro-consumer governing board • Multilingual access • Effective regulation

12. Exchange & SHOP: Making It Work for AAPIsRun by Ohio • Ohio should establish and operate the Exchange/SHOP • Avoid defaulting to a federal-level Exchange/SHOP unlikely to meet the needs of diverse AAPI groups in Ohio. • Including but not limited to the Burmese, Bhutanese, Hmong, Mon, Karen, and Nepalese refugee communities.

13. …and any individuals or organizations who may profit from enrollment in a health plan Hospitals Physicians Insurers Brokers Exchange & SHOP: Making It Work for AAPIs Pro-Consumer Governing Board • The board that designs and oversees the Exchange & SHOP must include • Consumer, labor, and small business representatives alongside industry experts. • An AAPI health expert among other minority health experts. • A strong conflict of interest clause that excludes those with financial interests in health care.

14. Exchange & SHOP: Making It Work for AAPIs Multilingual Access • The Exchange & SHOP should be accessible to limited English proficient communities: • Exchange website should have AAPI language support • Navigators for AAPI ethnic groups • Based in the communities they serve • Ethnically diverse • Culturally and linguistically competent

15. Bad example: Utah’s Exchange must accept all health plans Massachusetts: allows its Exchange to select bidding health insurers based on quality and value. Exchange & SHOP: Making It Work for AAPIs Effective Regulation • Ensure quality health plans in the Exchange & SHOP • The Exchange/SHOP should be able to accept or reject health plans for sale based on price and quality • Advocacy example: to be sold in the Exchange, a health plan must help reduce health disparities by offering customer service in AAPI languages andcovering prevention, treatment, and management of common AAPI conditions

16. Key Takeaways • The Exchange & SHOP give all Ohioans greater control over their health care (easy-to-use, comparison shopping website). • The Exchange & SHOP can and should be designed to benefit AAPI health interests.

17. Sources • “Asian Americans continued to suffer the most from long-term unemployment in 2011” (Economic Policy Institute) : http://www.epi.org/publication/ib323s-asian-american-unemployment-update/ • “Better Health Insurance Options for Ohio” (Ohio Consumers for Health Coverage” • “Essential Health Benefits Bulletin” (Center for Consumer Information and Insurance Oversight) Dec. 16, 2011 • “Exchanges: Top Ten Priorities for Consumer Advocates” (Community Catalyst) • “Summary of Coverage Provisions in the Patient Protection and Affordable Care Act” (Kaiser Family Foundation) • “Summary of New Health Reform Law” (Kaiser Family Foundation” • “Why We Need a Health Insurance Exchange” (Families USA) • http://erc.msh.org/provider/informatic/AAPI_Diabetes_Incidence.pdf • “The Health Care Law and You: What’s Changing and When”: http://www.healthcare.gov/law/timeline/