the affordable care act in arizona also known as
TRANSCRIPT
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The Affordable Care Act in Arizona
The Affordable Care Act in Arizona
Also Known As
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Questions to ExploreQuestions to Explore
What are the aims of the ACA? How many more Arizonans are
covered? How does it work? What can Assisters and Brokers do? Where can I find help?
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ACA – Triple AimACA – Triple Aim
Reduce number of uninsured
Reduce total healthcare expenses
Improve healthcare quality
Context
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Results
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Who is EligibleWho is Eligible
US Citizens
Lawfully Present
Deferred Action
Undocumented
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Coverage – Four Important FactsCoverage – Four Important Facts
How It Works
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Important Fact #1Important Fact #1
It’s Time
Health Insurance Marketplace Open Enrollment, Nov 1, 2015 to Jan 31, 2016
Special enrollment periods for life changes all year long; births, marriage etc.
AHCCCS (Medicaid) open year around
How It Works
For Jan 1 by Dec 15
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Important Fact # 2Important Fact # 2
8 out of 10 received financial assistance
Received an average of $155 a month to lower monthly premiums
86 out of 100 could have bought a plan for less than $100 a month.
How It Works
Arizonans:
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Important Fact # 2Important Fact # 2
Approximately 350,000 Arizonans are eligible
but not enrolled in free health care - AHCCCS
How It Works
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Marketplace Financial
Assistance
AHCCCS
Making Insurance AffordableMaking Insurance Affordable
3. Premium Tax Credits
400% FPL
$79,160 (3 people)
250% FPL
$49,475 (3 people)
138% FPL$27,724 (3 people)
2. Cost Sharing Reduction
1. Medicaid
AHCCCS
How it Works
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Making Insurance AffordableMaking Insurance Affordable
Family Size One Two Three Four Five
AHCCCS 138% $16,243 $21,983 $27,724 $33,465 $39,206
PTC & CSR 250% $29,425 $39,825 $50,225 $60,625 $71,025
PTC 400% $47,080 $63,720 $80,360 $97,000 $113,640
“The more you earn, the more you pay”
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Marketplace Financial
Assistance
Example Example
Premium Tax Credits
How it Works
Monthly Insurance Premium for the Family $400
Premium Tax Creditgoes to Insurance Co. - $200
Your share $200
When you pay your income tax, you balance the books; take more than you should – must give it back;
take too little, get a check.
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Marketplace Financial
Assistance
Example Example
• You pay for a Silver plan, but get a Gold plan.
• Your out-of-pocket costs to see a doctor, visit a hospital or get a prescription are less.
• Because you earn less, you get a reduction in your portion of the bill when you receive medical care.
Cost Sharing Reduction
How it Works
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A Few Simple StepsA Few Simple Steps
Create an Account Apply Pick a Plan Enroll & Pay
Determination Notice$$ Financial Aid $$
How It Works
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Get Covered or PayGet Covered or Pay
• $95 or 1% of income2014
• $325 or 2% of income2015
• $695 or 2.5% of income2016
“Whichever is greater”
How It Works
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Options for shopping & enrollingOptions for shopping & enrolling
Do It Yourself healthcare.g
ov
1-800-318-2596
BrokerAgent
1000’s to choose from
Assisters
One on one local help
$$ No charge to you – all are free $$
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Statewide SchedulingStatewide Scheduling
Talk to a Navigator
844.790.4946Appointments
www.coveraz.org/connector
How It Works
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Arizona’s largest primary care network; serving rural, urban and tribal areas
Comprehensive primary care, located in underserved areas, open to anyone with or without insurance coverage
Community Health Centers
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700 E. Jefferson Street, Suite 100 Phoenix, AZ 85034 (602) 253-0090 www.aachc.org