affordable care act health care reform and alabama

8/3/2019 Affordable Care Act Health Care Reform and Alabama

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Natalia Cales

Regional Outreach Specialist

U.S. Department of Health and Human Services

Region IV 1


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Mission:

At the Department of Health and Human Services,ourmission is to help provide the building blocks

that Americans need to live healthy,

successful lives.

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Strategic Initiatives

1.Transform health care2.Implement the Affordable Care Act3.Implement the Recovery Act4.Promote Early Childhood Health and Development5.Help Americans achieve and maintain healthy weight

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Strategic Initiatives

6.Prevent and reduce tobacco use7.Protect the health and safety of Americans in public

health emergencies

8.Accelerate the process of scientific discovery toimprove patient care

9.Implement a 21st century food safety program10.Ensure program integrity and responsible

stewardship

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Region IV States

Alabama

FloridaGeorgia

Kentucky

Mississippi

North CarolinaSouth Carolina

Tennessee

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Role of the Regional Director Implementation of health care reform

(priority #1).

Represent & communicate health carepolicies with federal, state, local, tribal, andterritorial government officials and key non-governmental external stakeholders.

Serve as a conduit with stakeholders on theirpriorities for policies, operations issues and

partner on activities and events. Department/Agency Collaboration Work across regional office and among all

regions to collaborate and coordinate on keyissues.

Anton J. Gunn, M.S.W.

Regional Director

Region IV


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After a year of striving, after a year of debate, after a

historic vote,Health Care Reform is no longer an unmet

promise. It is the law of the land.

- President Barack Obama


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Title I - Quality, Affordable Health Care for

All Americans

Title II - The Role of Public Programs

Title III - Improving the Quality and Efficiency

of Health Care

Title IV - Prevention of Chronic Disease and

Improving Public Health

Title V - Health Care Workforce

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Title VI - Transparency and Program Integrity

Title VII - Improving Access to InnovativeMedical Therapies

Title VIII - Community Living Assistance Services

and Supports Act (CLASS Act)

Title IX - Revenue ProvisionsTitle X - Reauthorization of the Indian Health

Care Improvement Act

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1. Expands Coverage

2. Offers New Consumer Protectionsand Consumer Choice

3. Makes Health Care MoreAffordable

4. Improves Quality5. Improves Prevention and Public

Health

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2010 2011 2012 2013 2014

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TIMELINE


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Quick Glance :

Banned discriminationagainst children with pre-existingconditions

Eliminated lifetime limits on insurance coverage Extended coverage to young adults (up to 26 years old) Reinsurance extended to early retirees (55-64 years old) Provided relief to nearly 4 million seniors - Medicare donut

hole $250rebate checks Cracked down on health care fraud - $4 billion recovered CreatedHealthCare.gov internet web portal to provide plan

choices and other helpful information for consumers


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Quick Glance :

Discounts on Medicare prescription drug 50% offof brandname drugs and annual wellness visit are free.

Expands community health centers and increases access tohealth services at home.

Adds transparency, strengthens State premium oversight,Medical Loss Ratio (MLR) review.

Provides additional resources to enhance states HealthInformation Technology (HIT) capabilities.

Increases Medicaid payments for primary care services.


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Quick Glance:

Expands Coverage to 32 million in 2014(92% of non-elderly population)

Will establish state-based Exchanges, creating newcompetitive health insurance marketplace- These exchanges will offer individuals and small businesses achoice of affordable, quality plans

Medicaid Expansion to 133% of FPL = $29K, family of 4 Bridge Programs to 2014

-Pre-Existing Condition Insurance Plan (PCIP)

- Early Retiree Reinsurance Program (ERRP)

- Small Business Health Insurance Tax Credits

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2010 Exchange planning grants, IT systems & federal policymaking.

2011 States enact legislation & federal rules issued.

2012 States notify HHS of intent to run exchanges and begin to qualify plans.

2013 Exchanges bring IT systems online and ensure operation before enrollment.

2014 Exchange-provided coverage is in effect, tax credits begin (1/1/2014).

Planning for

Health Insurance Exchanges


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Affordable Insurance Exchanges will create:

Lower Costs: The Exchanges will increase competitionamong private insurance plans.

One-Stop Shopping: The Exchanges will make purchasinghealth insurance easier.

Greater Benefits and Protections: The Exchanges will createa health insurance marketplace with a variety of high quality

plans for employers, individuals, and families.


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SE Region

$512.2million

Alabama

$16.8million Florida

$110.4million

Georgia

$36.9million

Kentucky

$35.9

millionMississippi

$45.5million

N. Carolina

$81.1million

S. Carolina

$16.8million

Tennessee

$168.9million


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Medicare

RebateChecks

PCIP ERRP

CAPTax

Credits

CommunityHealth

CentersHealthcare

ProfessionalExpansion

Public

Health

Prevention

Fund

ACA

Limited List Highlighted Below


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Since enactment of the Affordable Care Act (ACA) on March

23, 2010, the Department of Health and Human Services

has awarded $16.8 millionin new grant funding inAlabama, and helped many residents and employers take

more control of their health care from new patient

protections to new coverage options.*

*The following information is a selection of programs funded by the Affordable

Care Act and does not add up to the total Affordable Care Act funding for the

State of Tennessee.

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57,598 Medicare Part D Donut Hole $250 Rebate Checks

7,302Medicare beneficiaries of Alabama have alreadyreceived a free annual wellness visit this year.

$1 million Health Insurance Exchangeplanning grant

$1 million to crack down on Unreasonable InsurancePremium Increases


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$3.7 million in Therapeutic Discovery Project Program TaxCredits and Grants from the IRS

$961,392 forMedicare improvements for patients andproviders

$6.1 millioninvestment in Community Health Centers $3.9 million from the Prevention and Public Health Fund $3.4 million forcommunity and clinical prevention

activities

$560,000 to support public health infrastructure


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42 employers enrolled in Early Retiree ReinsuranceProgram Alabama employers have already received $13.8

million in reimbursement.

Limited list of Alabama employers include:Decatur Utilities Blue Cross and Blue Shield of Alabama

City of Huntsville Utilities City of Huntsville General Activities

DCH Healthcare Authority Tombigbee Healthcare Authority

Council of the City of Anniston

State Employees' Insurance BoardMercedes-Benz U.S. International, Inc.

Public Education Employees' Health Insurance Plan


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167uninsured Alabama residents enrolled in the Pre-ExistingCondition Insurance Plan (PCIP). In Alabama, the PCIP isoperated by the Federal government and provides a health

coverage option for consumers who have been:uninsured for at least six months,have a pre-existing condition or have been denied health coverage

because of their health condition, and

are a U.S. citizen or are residing here legally. Visit www.pcip.gov or call 1-866-717-5826 for additional

information, application process, and rates.


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Standard Option Extended Option HAS Option

Premium range (permonth; varies by age)

$93 - $578 $125 - $778 $97 - $600

Medical deductible(per year)

$2,000 $1,000 $2,500

Drug deductible(per year)

$500 $250 Included in medical

coverage

Office Visit (per visit) $25 $25 $25

Drug copay(per prescription) $4 for generic$40 for brand

25% for specialty

$4 for generic$30 for brand

25% for specialty

$4 for generic$30 for brand

25% for specialty

Annual out-of-pocket

limit (in-network)

$5,950 $5,950 $5,950

Summary of 2011 Plan Options & Premium*(In-network benefits)

*For information on coverage, benefits, and premiums by state, visit ww.pcip.gov


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Alabama Department of Public Health

Office of Minority Health

The Office of Minority Health (OMH) facilitates local andstate level partnerships to address health disparities in

Alabama.

Grant funds through the Federal Office of Minority Healthprovides support to the state efforts to improve the health of

racial and ethnic minorities. Received $140,000 through the State Partnership Grant


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Alabama OMH provides the following activities:1. Health Education Programs

Community & Provider Settings2.

Cultural Competencies Minority Health Issues

3. National Partnership for Action (NPA) Implement Action Plan & Strategy

4. Satellite Conference & Live Webcast Professional Development & Distance Learning

5. Technical Assistance Train-the-Trainer Programs


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Upcoming Satellite Conferences & Live Webcasts(Potential CEUs are available - http://www.adph.org/alphtn/)

Friday 8/26/2011 1:30 2:30 pm (CST) Reducing Health Disparities by Promoting Health Equity

in Alabama

Wednesday 9/14/2011 2:00 3:00 pm (CST) Mental Health Issues in Underserved Youth


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Contact Information:

Alabama Department of Public Health

Office of Minority Health

The RSA Tower

201 Monroe Street, Suite 710

P.O. Box 303017

Montgomery, Alabama 36130

Phone: (334) 206-5396Toll-Free: (800) 255-1992

www.adph.org/minorityhealth


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REACH Racial & Ethnic Approaches to Community Health

across the U.S.

REACH U.S. is a CDC project designed to serve as a nationalclearinghouse and important cornerstone of evidence-based and

promising practices to eliminate racial and ethnic health disparitiesin the United States.

The University of Alabama at Birmingham serves as the centralcoordinating organization for REACH U.S.

AL REACH program addresses breast and cervical cancer disparities


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AL REACH -

Legacy Funding

The REACH U.S. Center of Excellence in EliminatingDisparities (CEED) announces a funding opportunity for

organizations to apply for legacy funds each year, usually due

in August.

Funds are used to: address breast and cervical cancerdisparities among African American women using evidence-based strategies and/or promising practices.

http://mhrc.dopm.uab.edu/REACHUS/grantfunding.html


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Contact Information:

AL REACH

Minority Health & Health Disparities Research Center,

University of Alabama at Birmingham (UAB)

Dr. Theresa Wynn, PhDProgram Director

University of Alabama at BirminghamSchool of Medicine - Division of Preventive Medicine

Medical Towers Building1717 11th Ave. South, Suite 516A

Birmingham, AL 35294-4410

Phone: 205-934-6892Email: [email protected]

Website: www.UABMHRC.com/REACHUS


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TheAffordable Care Actprovides a strong platform

for change -- expanding coverage, protectingpatients, lowering costs and shifting incentives to

rewardvalue over volume.

-Secretary Kathleen SebeliusNovember 9, 2010

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Natalia CalesRegional Outreach Specialist

U.S. Department of Health and Human Services (Region IV)

61 Forsyth St., SW Suite 5B95

Atlanta, GA 30303-8909

Region IV - AL, FL, GA, KY, MS, NC, SC, TN

Office: (404) 562-7888

Fax: (404) 562-7899

[email protected]

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affordable care act health care reform and alabama

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