webinar health reform in florida and the impact on
TRANSCRIPT
Health reform in Florida and the impact on its children
Thursday, December 6 11:45 am to 12:30 pm
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Today’s program
Introduction
Children’s coverage and the ACA – Joan Alker, Georgetown University Center for Children and Families
2012-2013 Opportunities and Goals for Child Health
Advocacy– Diana Ragbeer, The Children’s Trust of Miami Dade
Q & A
Joan Alker
How is Florida doing in covering kids?
Uninsured Children in Florida
Percent of Uninsured Children
2011 State Ranking in Percent of Uninsured Children
Number of Uninsured Children
2011 State Ranking in Number of Uninsured Children
Florida 11.9% 48th 475,112 49th
National
7.5% -- 5,527,657 --
Florida – 3rd in Percentage Point Change of Uninsured Children
2009-2011 Percentage Point Change
Rank 2009-2011 Percentage Point Change
United States -1.1 -
Florida -2.9 3
Source: “Uninsured Children 2009-2011: Charting the Nation’s Progress” Georgetown Center for Children and Families, October 2012.
Florida vs. Neighboring states: Rate of uninsured children in 2011
Florida 11.9%
Alabama 5.3%
Georgia 9.5%
Louisiana 5.8%
South Carolina 8.4%
Joan Alker
What are the key issues for kids in the ACA?
Children’s Coverage in Florida, 2014
Key ACA issues for children
•Maintenance of effort which prohibits states from rolling back eligibility for adults until 2014; children 2019.
•This includes proposals to make it harder for people to enroll such as premiums or other ways in which a state might add “red tape.”
Key ACA issues for children•Alignment of eligibility for children below 133% FPL i.e. “stairstep kids”.
•Intersection between Exchange and Medicaid/Healthy Kids with respect to enrollment practices
•Extending Medicaid coverage for parents and other adults• Moving to family based coverage
Policy and Procedural Changes Under ACA•No wrong door – coverage is coordinated regardless of point of entry
•Multiple paths to enrollment, renewal, reporting changes – online, phone, in-person, mail
•Eligibility – data-driven, technology-enabled, real-time
•Automated renewals using available data•Navigators and enhanced consumer assistance
Current Eligibility Levels
How many Floridians would gain coverage?
•We estimate that 815,000 to 1,270,000 adults and children would gain coverage if the state extended Medicaid to parents and other adults below 133% FPL
Joan Alker
Why would children get coverage?•Coverage is being extended for parents and adults – the “newly eligible”
•But we know that more current eligibles will get enrolled as a result of the “welcome mat” effect. Most of these “eligible but unenrolled” will be children.
Different federal matching rates apply•“Newly eligible” are funded at 100% federal cost for FY2014-2016; tapers down to 90% over the next seven years;
•Current eligibles get regular Medicaid match rate (58%) or CHIP match rate (71%)
•Participation rates are likely to go up even without Medicaid extension because of new “culture of coverage”
Who Will remain uncovered w/o broader Medicaid coverage?
New Medicaid enrollment if changes occur
Adults newly
eligible for Medicaid
Adults currently
eligible for Medicaid
Children currently
eligible for Medicaid
Total
Total uninsured 1,295,000 257,000 500,000 2,052,000Projected take-up rate (low assumption)
57% 10% 10%
Number projected to gain Medicaid coverage (low assumption)
740,000 25,000 50,000 815,000
Projected take-up rate (high assumption)
75% 40% 40%
Number projected to gain Medicaid coverage (high assumption)
970,000 100,000 200,000 1,270,000
Bottom line
•Florida incurs few costs for adults newly eligible for Medicaid, slightly higher costs for new enrollment by those already eligible.
•But savings due to more coverage should more than offset costs.
•New coverage has positive effects for health and quality of life
Diana Ragbeer
2012-2013Opportunities and Goals for Child
Health Advocacy
Alignment with CHIPRA/Continuation Opportunities
•Extend coverage to all children who are eligible and qualify for the enhanced federal match under provisions of the Children’s Health Insurance Program Reauthorization Act (CHIPRA).
• Reinstate and implement presumptive eligibility for all Florida KidCare program components.
Alignment with CHIPRA/Continuation Opportunities
•Implement 12-month continuous eligibility to promote health outcomes and quality of care for children enrolled in all Florida KidCare program components. (Currently, children ages 6-19 with incomes below the poverty level are excluded while more moderate-income children of the same age qualify).
Administrative Efforts
•Implement “express lane eligibility” in KidCare to expedite enrollment by using information from other public programs (such as school district free and reduced lunch data)
Affordable Care Act• Ensure that all adults who are newly eligible for Medicaid under the Patient Protection and Affordable Care Act (up to 138% of the federal poverty level) are extended coverage under Florida law. (When parents gain coverage, children gain coverage, and economic security for the entire family is improved)
Diana Ragbeer
Affordable Care Act Alignment with Changes in Federal LawFlorida must revise state statue and/or regulations to ensure compliance with federal law in these areas:
•Align Medicaid coverage to 138% of the federal poverty level for children of all ages. Shifting children from Healthy Kids to Medicaid will keep children in the same family in the same program, thereby improving administrative efficiency
•Increase Medicaid reimbursement rates for primary care providers to assure access to care, drawing down 100% federal funding to boost rates to Medicare levels
Affordable Care Act Alignment with Changes in Federal LawFlorida must revise state statue and/or regulations to ensure compliance with federal law in these areas:
•Ensure that federal funds are appropriated to implement the “no wrong door” state law that requires Florida to upgrade, coordinate and increase the efficiency of enrollment and eligibility systems.
Thanks for joining us!
www.kidswellflorida.org