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The Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act. Young Adult Outreach and Education. Who Doesn’t Have Insurance? . 15.7% of residents in the U.S. lack insurance 26.9 % of 18-34 year olds in the US lack insurance. 16.9% of residents in Idaho lack insurance

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The Patient Protection and Affordable Care Act

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

  2. Who Doesn’t Have Insurance? 15.7% of residents in the U.S. lack insurance 26.9% of 18-34 year olds in the US lack insurance • 16.9% of residents in Idaho lack insurance • 29.3% of 18-34 year olds in Idaho lack insurance

  3. Who are Young Invincibles?

  4. Overview How does the ACA affect young adults How do we talk to young adults about health care?

  5. ACA Provisions Already in Effect that Help Young Adults

  6. What’s Already in Effect Dependent Coverage Free Preventive Care No denial for pre-existing condition for under 19 Student Health Plans Women’s Health Contraception Community Health Centers

  7. Dependent Coverage and Preventive Care 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

  8. Student Health Plans • Previously limited regulations • Now subject to standardized ACA requirements • Must include preventive care benefits • 80/20 Ratio

  9. Women’s Health Benefits • 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 • Religious institutions - exempt • Religiously-affiliated institutions - 1 year delay • After Aug. 2013, employees and students get coverage directly from insurance companies

  11. Growth of Community Health Centers (CHCs) • Currently 8,000 CHCs provide care to 20 million individuals • In June 2012 grants went to 219 CHCs around the country • Increased number of patients served by 1.25 million

  12. What Changes Will Come in 2014?

  13. Changes to Come Medicaid Expansion Subsidies Exchanges/Marketplaces Individual Mandate

  14. Idaho and Medicaid • Currently eligible: • Children under 19 • Low income parents • Pregnant women • Disabled • Eligible in 2014: • EVERYONE <133% of FPL • States can decide whether to expand further • Governor-appointed working group recommended expansion to 138% FPL Photo source: http://www.statesymbolsusa.org/Idaho/seal_idaho.html

  15. Potential Benefits of ACA Implementation in Idaho Total State Population All ages

  16. Subsidies/Tax Credits • 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 $14,856 • 400% of FPL for 1 person is $44,680

  17. How Much of a Subsidy? • Four tiers of plans – Bronze, Silver, Gold, and Platinum • Subsidies are calculated based on Silver plan • Individuals can use subsidy for any plan

  18. Ex-cha-cha-cha-Changes Shop for insurance Each state is different, some will have federally-facilitated exchanges (FFEs) or partnerships Subsidies applied directly (only through exchanges) Idaho is still deciding what type of exchange the state will have

  19. How many young people in Idaho could get benefits?

  20. Exchanges in the States • Idaho has not decided if it will build a state exchange or utilize the federal option • Has an extended December 14 deadline to make that decision. • Governor Otter supports setting up a state exchange • Legislation did not pass this year

  21. Other important parts of the ACA • Catastrophic plans • Marketed to the young • Targets those with financial hardship • No Annual Limits in 2014 (already phasing out) • Tax Credit for employers (already started) Picture Source: http://wymancenter.org/the-importance-of-bulking-up-the-muscle-of-perseverance/

  22. Individual Mandate and Penalties • Individuals must have qualifying health insurance • If not, penalties • $95 the first year • Rises in 2016, ex. $695 • Exemptions Picture Source: http://thepinkleague.com/2012/08/30/so-whats-the-lowdown-the-basics-of-football-part-2/

  23. Jessica, 19 years old Part-time student, part-time job $10,000/year before taxes~ 87% of poverty Without Medicaid expansion, she doesn’t qualify for Medicaid and would not have health insurance

  24. Jeff, 21 years old Part-time student, full-time construction worker Earns $23,000/year Takes home: $1,438/month Total health premium: $283/month With tax credits he pays: $121/month

  25. Overview: ACA and Young Adults • Young adults have high rates of uninsurance • The ACA has many provisions that help young adults • Dependent Coverage • Student Health Plans • Contraception and Women’s Health • Changes to come • Expanded Medicaid • Subsidies • Exchanges • Individual Mandate

  26. Outreach and Education for Young Adults in Idaho

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

  28. Health Care Outreach • Traditional Outreach • Tabling • Group presentations • Hosting events • New Outreach Strategies

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

  30. Find a Doctor • Find doctors and Community Health Centers in your area • Search by location with GPS or zip code • Search by name or category • Shows user ratings of doctors in the area

  31. Healthcare FAQ Explains how to find health insurance for different people (students, chronic conditions, buying your own plan) Explains the health care law Defines common health insurance terms

  32. Waiting Room Game Fun game for people to play while passing time in the waiting room

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

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

  35. Navigators & Assisters • State exchanges – formal “Navigator” program • Funded through State’s Exchange • Aids with outreach and enrollment • States with federal exchanges– assisters will provide help on outreach

  36. Timeline: What to Look For • 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 1st, 2013 – March 31st, 2014 • Open enrollment for exchanges • Ensure young adults are getting subsidies and Medicaid, if possible

  37. Key Takeaways @YI_Care • ACA is phasing in, some changes already underway • Outreach and education • Traditional outreach • Social media and mobile technology • Big changes in 2013 • Like us on Facebook • Follow us on Twitter

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