affordable care act: what public policy leaders should know and do - paul beddoe
DESCRIPTION
NACo Deputy Legislative Director of Health Paul Beddoe discusses what public policy leaders should know and do about the Affordable Care Act during a North Carolina Association of County Commissioners seminar held Oct. 15, 2013, in Orange County, N.C.TRANSCRIPT
County Commissioners and Managers: What Public Policy Leaders Should Know & Do
NCACC Affordable Care Act Seminar Orange County/Chapel Hill
October 15, 2013
Presentation Overview
WWW.NACO.ORG | MAY 2013
About NACo
The Context – Why health reform? How did we end up with the ACA?
County policy options under the ACA
Coverage expansion Medicaid & the Safety Net Public Health: Disease Prevention & Health Promotion Jail Health
About NACo
WWW.NACO.ORG | MAY 2013
The National Association of Counties (NACo) assists America's counties in
pursuing excellence in public service by advancing sound public policies,
promoting county solutions and innovations, fostering intergovernmental and public-
private collaboration and providing value-added services to save counties and
taxpayers money
Founded in 1935, NACo provides the elected and appointed leaders from the
nation's 3,069 counties with the knowledge, skills and tools necessary to
provide fiscally-responsible, quality-driven, and results-oriented policies and services
for healthy, vibrant, safe and resilient counties
The Context
WWW.NACO.ORG | MAY 2013
Counties: “Where the Rubber Meets the Road”
Unique Role of Counties: Providers, Payers, Purchasers
Highly polarized political debate
The Context
WWW.NACO.ORG | May 2013
The Context
WWW.NACO.ORG | May 2013
The Context
WWW.NACO.ORG | May 2013
The Context
WWW.NACO.ORG | May 2013
The Context
WWW.NACO.ORG | May 2013
NACo and Health Reform
WWW.NACO.ORG | May 2013
2008 – NACo President appoints Health System Reform Working Group Working Group holds three hearings around the country Working Group drafts a White Paper proposing NACo priorities in health reform The White Paper is debated, amended and approved by the NACo Health Steering Committee, NACo Board and NACo Membership
County Policy Options
WWW.NACO.ORG | May 2013
Coverage expansion Individual mandate
Define role for county agencies Community leadership role
Employer mandate
Set county employee health benefit policy If continuing to offer coverage, design benefit to comply with ACA Consider workplace wellness incentives
County Policy Options
WWW.NACO.ORG | May 2013
Medicaid & the Safety Net
Medicaid for all up to 133% FPL – state option Pass through for counties required to contribute to non-federal share
$14.1 billion cuts to DSH 2014-2019, cuts extended into out years
New requirements for NFP hospitals
County Policy Options
WWW.NACO.ORG | May 2013
Public Health: Disease Prevention & Health Promotion
Prevention & Public Health Fund: “… to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs”
Source: Sarah Kliff Workblog.washingtonpost
County Policy Options
WWW.NACO.ORG | May 2013
Public Health: Disease Prevention & Health Promotion, cont’d.
Community Transformation Grants (CTG) Public Health Workforce Public Health Improvement Initiative (PHII)
Section 317 Immunization Program Epidemiology and Lab Capacity (ELC) Grant Program
County Policy Options
WWW.NACO.ORG | May 2013
Jail Health
Persons in custody pending disposition of charges retain eligibility for QHP coverage on the exchanges
Screen inmates for eligibility? Enroll? Pursue billing for services?
Medicaid? We’re working on it …
For questions or more information, feel free to contact us Contact Us!
Questions?
Deborah Cox: Legislative Director [email protected] or 202.942.4286 Paul Beddoe: Deputy Legislative Director/Health [email protected] or 202.942.4234 Michael Belarmino: Finance & Intergovernmental Affairs [email protected] or 202.942.4254 Daria Daniel: Community and Economic Development [email protected] or 202.942.4212 Bob Fogel: Transportation [email protected] or 202.942.4217
Arlandis Rush: Justice and Public Safety [email protected] or 202.942.4236 Arthur Scott : Agriculture and Rural Affairs [email protected] or 202.942.4230 Ryan Yates: Public Lands [email protected] or 202.942.4207 Julie Ufner: Environment, Energy & Land Use [email protected] or 202.942.4269 Yejin Jang: Telecommunications and Technology [email protected] or 202.942.4239
Matthew Chase, NACo Executive Director [email protected]
NACo was named one of nine remarkable associations in the United States after a four-year study conducted by the American Society of Association Executives and The Center for Association Leadership because of its commitment to members and purpose