toward a new horizon: the remaining uninsured & prospects for coverage and care january 23, 2014
TRANSCRIPT
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
www.nclr.org/healthcareforall