Download - TOWARD A NEW HORIZON: THE REMAINING UNINSURED & PROSPECTS FOR COVERAGE AND CARE January 23, 2014
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TOWARD A NEW HORIZON: THE REMAINING UNINSURED
& PROSPECTS FOR COVERAGE AND CARE
January 23, 2014
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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?
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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
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The Remaining Uninsured
ACA ≠ universal coverage
• 26 million estimated to remain
uninsured – Eligible and uninsured– Ineligible and uninsured
• Informal and structural barriers
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The Remaining Uninsured
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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
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Select Barriers to Insurance
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Potential Pathways for Coverage and Care
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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
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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
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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
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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
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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
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Steven LopezSenior Health Policy AnalystNational Council of La Raza
www.nclr.org/healthcareforall