toward a new horizon: the remaining uninsured & prospects for coverage and care

TOWARD A NEW HORIZON: THE REMAINING UNINSURED

& PROSPECTS FOR COVERAGE AND CARE

January 23, 2014

Overview

• How does the ACA impact minority communities?

• Who is likely to remain uninsured?

• What are key barriers to insurance?

• What are potential pathways for coverage and care?

Impact on Minority Communities

• Projected to increase health insurance to 32 million individuals

• 6.8 million African-Americans eligible for Marketplace coverage

• 10.2 million Latinos eligible for Marketplace coverage

• Investments in prevention to address chronic disease

The Remaining Uninsured

ACA ≠ universal coverage

• 26 million estimated to remain

uninsured – Eligible and uninsured– Ineligible and uninsured

• Informal and structural barriers

The Remaining Uninsured

The Remaining UninsuredMedicaid Expansion

• Key coverage vehicle in ACA

• 2012 Supreme Court decision– 26 expansion states; 25 non-expansion

• 5 million in “coverage gap”– disproportionate effect on minorities

• 2.6 million (53%)

– South acutely affected • TX, FL

Select Barriers to Insurance

Potential Pathways for Coverage and Care

State and Local Pathways

Washington Apple Health for Kids

• Health insurance for children up to 300% FPL

• Eligibility depends on income, eligibility for other programs, but not immigration status

• Comprehensive benefits

• Over 500,000 currently enrolled

State and Local PathwaysCareLink • Financial assistance program • Eligibility depends on income, eligibility for

other programs, and Bexar County residency• Members assigned PCP and medical home• Benefits include preventive care, mental

health, and prescriptions

Alternative Pathways

Restaurant Opportunities Center United’s

MD-Program• Health care cooperative• Pilot program launched in 2011 in Los

Angeles• Eligibility does not depend on income or

immigration status • $20 premium and $5 ROC-LA membership

Alternative PathwaysAccess to Healthcare Network (AHN)

• Coordinated network of providers

• Shared responsibility model

• Focuses on health care needs of those between100%-250% FPL

• Caters to those either statutorily ineligible or have legal opt-out of individual mandate

Alternative PathwaysBinational or Cross Border Insurance• Insurance products targeted to uninsured

Mexican-born population living in the United States

• Sistems Medicos Nacionales, Salud con Health Net and Salud Mexico, Blue Shield Access Baja

• Mexican Social Security Institute (IMMS), Seguro Popular

• CA only demonstration site

Steven LopezSenior Health Policy AnalystNational Council of La Raza

slopez@nclr.org202-776-1809

www.nclr.org/healthcareforall