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Affordable Care Act: Implementation in Illinois

Affordable Care Act: Implementation in Illinois. Implications for Low Income Populations and Legal Services Attorneys. The Affordable Care Act: Quick Review. Medicaid Expansion to 138% FPL for adults ( CountyCare Early Implementation)

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Affordable Care Act: Implementation in Illinois

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  1. Affordable Care Act: Implementation in Illinois Implications for Low Income Populations and Legal Services Attorneys

  2. The Affordable Care Act: Quick Review • Medicaid Expansion to 138% FPL for adults (CountyCare Early Implementation) • Marketplace Insurance with Financial Help including Premium Tax Credits to 400% FPL and Cost-Sharing Subsidies to 250% FPL • Insurance Reforms: Guaranteed Issue, Rating, Pre-existing Conditions • Individual and Employer Mandates

  3. Recall the uninsured who qualify for the Marketplace

  4. Important Timelines • Open Enrollment for Marketplace = October 1, 2013- March 31, 2014 • Purchase insurance on Marketplace by December 15, 2013 to ensure coverage by January 1, 2014. • Enroll in Medicaid anytime but outside of Cook County, new adult group begins coverage January 1, 2013.

  5. Who helps navigate the Marketplace?

  6. Where to Begin the Path to Coverage If potentially eligible referred to Medicaid/CHIP 1111111111111111111111111111111111111111 1111111111111111111111111111111111111111

  7. * lawfully present residents below 100% FPL and ineligible for Medicaid may qualify

  8. What Benefits Can a Person Apply for Through ABE?

  9. New Medicaid and Marketplace Methodology • For New Adult Group, All Kids and Family Health Plans: Use Modified Adjusted Gross Income Test and no asset test. • For Existing AABD Medicaid: Use existing Medicaid income methodology with asset test. • MAGI combines tax status, household, income and existing Medicaid rules.

  10. Non-Citizen Eligibility • Medicaid eligibility remains the same: LPR over 5 years, refugee/asylee, children, pregnant women, emergency. • Marketplace eligibility is more liberal: lawfully residing may buy at any income level and receive financial assistance.

  11. Shared Responsibility (the mandate)

  12. Exemptions from the mandate

  13. Contact Information and Resources www.illinoishealthmatters.org www.healthcare.gov Stephanie Altman Health & Disability Advocates saltman@hdadvocates.org www.hdadvocates.org 312-265-9070

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