S.C. Alliance of Health Plans

SCAHU Annual SymposiumMarch 24, 2015

What is the SCAHP?

For over 20 years the South Carolina Alliance of Health Plans has been the

state’s leading voice for market driven innovation and solutions to health care

challenges.

What does the Alliance do?• Legislative advocacy on health plan related issues• Works with state regulatory agencies to develop transparent and

effective regulatory frameworks for • public health care (Medicaid)• commercial health plans

• Educates the media, consumers and employers about health care quality, provider accountability and affordability

• Engages the community on disease management and education

SCAHP Health Plan Members

SCAHP Partner Members

SCAHP Associate Members

SCAHP & SCAHU Partnership

• Legislative and Regulatory Advocacy

• Grassroots Mobilization

• Coalition Building and Collaborating to Lead Industry

• Educating Policymakers, Consumers and the Media

What do Americans want from Government today?

National Poll: Spend more, tax less,

legalize pot

Source: www.apnorc.org 3.20.15

Legislative Advocacy

• H.3020 (Chumley) and S.103(Bright) – Freedom of Choice in Health Care Act/Navigator Background Checks

• S.135 (Cleary) Ryan’s Law – Autism Mandate Expansion

• S. 314 (Campsen) – Healthcare Sharing Ministries

2015 Legislative Session

• H.3144 (Ryhal) – Navigator Background Check Act

• H.3252 (Stavrinakis) – Election of the Director of the SCDOI

• H.3490 (Quinn) – Business License Tax Reform Act

2015 Legislative Session

• H.3022 (Chumley) – Prohibit Recognition & Benefits to Same-sex Marriage Persons

• H.3448 (Hardee) – Air Ambulance Affordable Act

• H.3726 (Mack) – Palmetto Comprehensive Health Care Act

2015 Legislative Session

ACA Impact on SCAHP & SCAHU• DOI Regulatory Control

• Consumer Protection Services

• Navigators

• Ever Changing Enforcement Rules

• Current ACA Subsidy Litigation, King v. Burwell

King v. Burwell

“… Exchange established by the State.”

SC Enrollment Numbers as of March 2, 2015

• 173,855 individual have enrolled in the FFE

• They represent 77.88% of the 223,237 individuals that have enrolled in a 2015 Qualified Health Plan (QHP) for individual market coverage on the FFE. This includes automatic renewals for qualifying individuals that had a 2014 plan through one of the FFE carriers.

Current South Carolina ACA Data

• 90.7% are receiving a federal subsidy, which means they are between 100% and 400% of the Federal Poverty Level

• 62.08% are receiving both federal subsidies, which means they are between 100% and 250% of the Federal Poverty Level

• The average age is 42.49 years old (compared to 37.31 years old for the 28,024 individuals that have coverage through a 2015 Plan sold outside the FFE from one of these same five carriers)

Current South Carolina ACA Data

Uninsured Choose Penalty, Pass Up Enrollment Offer

Individuals are choosing to pay fine vs. pay for coverage.• 31% of the people surveyed said that “That they don’t need health

insurance and the penalty is less expensive than coverage”• Ex: 59 year old male in Florida

• $250 fine vs. $400 in monthly premium and $6,000 deductible.

• 41% of uninsured are unaware of the penalty for not having insurance.

Obama Administration sent out 820,000 incorrect tax statements about 2014 health care coverage. This is causing consumers to wait to file returns or file amendments to their returns.

Source: The Wall Street Journal

Current National ACA Data

Current National ACA Data

SC DOI Engagement• Meetings with Director and key staff to address industry

issues

• Navigators and Agent issues

• Post King v. Burwell planning

Resources for SCAHU, Public and Media

SCAHP Annual Health Care Conference

SCAHP Annual Health Care Conference

Over 7 Hours of

Continuing Education Credit

Offered

Opportunities to Get Involved

• Quarterly Meetings with speaking opportunities

• SCAHP Annual Health Care Conference

• SCAHP Foundation

Thank You!

Jim RitchieExecutive Director

SC Alliance of Health Plansjritchie@scalliance.org