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Moving Our Commonwealth Forward

Moving Our Commonwealth Forward. This Is Kentucky. This Is Kentucky, Too. Ranks 44 th in health status Highest smoking rate in the U.S. 1 million+ obese adults State with the highest rate of preventable hospitalizations 640,000+ Kentuckians without health insurance

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Moving Our Commonwealth Forward

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  1. Moving Our Commonwealth Forward 1

  2. This Is Kentucky 2

  3. This Is Kentucky, Too 3 • Ranks 44th in health status • Highest smoking rate in the U.S. • 1 million+ obese adults • State with the highest rate of preventable hospitalizations • 640,000+ Kentuckians without health insurance • Even with 2014 Medicaid expansion, uninsured will total more than 300,000 Sources: www.chfs.ky.gov Www.healthbenefitexchange.ky.gov

  4. What’s To Be Done? 4 • Call it what you wish: • Patient Protection and Affordable Care Act (PPACA) • Affordable Care Act • Obamacare • Health reform … it adds up to change.

  5. Health Cooperatives: Born of Compromise • The Affordable Care Act, passed into law in March 2010, provided seed money to fund health cooperatives. Kentucky’s own Henry Clay, drawn by P.F. Rothermel (1817–1895), engraved by R. Whitechurch (1814–ca. 1880). 5

  6. Health CO-OPs Voluntary and open membership Member-governed Member economic participation Autonomy and independence 6 Education, training and information Cooperation among cooperatives Concern for community

  7. Essential Health Benefits All Qualified Health Plans must include: Hospitalization Emergency services Prescription drugs Outpatient/clinic services Mental health and substance abuse services Maternity and newborn care 7 Laboratory services Rehabilitative and habilitative services and devices Preventive/wellness services and chronic disease management Pediatric services

  8. Kentucky Health Cooperative 8 • Licensed, nonprofit health insurance carrier. • Headquartered in Louisville; serving all 120 Kentucky counties. • A Consumer-Operated and Oriented Plan (CO-OP) defined under Section 1322 of the Affordable Care Act.

  9. Kentucky Health Cooperative: DNA 9 A fully-regulated health insurance issuer Not a federal or state agency Not to be confused with the Kentucky Health Benefit Exchange

  10. More About Kentucky Health Cooperative 10 Sponsored by a coalition of health care providers and business leaders Incorporated in 2011 as a nonprofit Governed by formative board of directors Charge: Meet widespread needs for greater access to affordable coverage, high quality care at lower costs

  11. Introducing Consumers to Us 11 Kentucky-based Board members live and work in Kentucky Journey from formation board to elected board Will offer multiple plan choices meeting a range of consumer needs represented by a diverse population

  12. Kentucky Health Benefit Exchange www.kynect.ky.gov 12 • It’s the online marketplace offering choice • Individuals and employees of small businesses

  13. Premium Assistance 13

  14. Example of Premium Assistance Amount (Family of four, varying income levels) 14

  15. SHOP Small Business Health Options Program 15 Own a small business? Employed by a small business?

  16. SMALL BUSINESSES Companies with fewer than 50 workers will not be penalized if they do not provide healthcare coverage. Starting October 1, small businesses can elect to purchase insurance for their employees at any time, with coverage beginning as soon as January 2014. 16

  17. Magic Numbers 17 • Small businesses may qualify for tax credits if : • there are less than 25 full-time employees; • average annual wage is less than $50,000, and; • employer pays at least 50% of the premium for each employee.

  18. Example: Small Business Tax Credit *Note: Check with the IRS for applicable rate information. 18

  19. What’s Next 19 • State Exchange went “live” on October 1 • Kynect.ky.gov • Carriers, plans, premiums listed • easy comparison, selection • Enrollment help available throughout Ky communities • Enrollment runs October 1 – March 31 • Coverage starting as soon as January 1, 2014

  20. Outreach Can you lend a hand in helping spread the word? 20 Mary Volkerding Kentucky Health Cooperative mvolkerding@mykyhc.org 502.498.5549

  21. MORE INFORMATION Kentucky Health Benefit Exchange www.kynect.ky.gov Kentucky Health Cooperative www.mykyhc.org Affordable Care Act, Health Insurance Exchanges and CO-OPs: www.Healthcare.gov Kaiser Family Foundation www.kff.org Health Insurance Marketplace http://marketplace.cms.gov/ 21

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