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S.C. Alliance of Health Plans SCAHU Annual Symposium March 25, 2014

S.C. Alliance of Health Plans SCAHU Annual Symposium March 25, 2014. What is the SCAHP?. For nearly 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?.

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S.C. Alliance of Health Plans SCAHU Annual Symposium March 25, 2014

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  1. S.C. Alliance of Health Plans SCAHU Annual Symposium March 25, 2014

  2. What is the SCAHP? For nearly 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.

  3. Whatdoes the Alliance do? Our broad coalition is united in its commitment to: • Responsible and effective legislative advocacy on health related issues • Working with regulators to develop transparent and effective regulatory frameworks for public and commercial health plans • Educating consumers and employers about health care quality and affordability • Engaging the community on disease management and education

  4. Our Members!Health Plan Members

  5. Our Members!Partner Members

  6. Our Members!Associate Members

  7. Our Members!Associate Member

  8. Our Members!Associate Members

  9. SCAHP & SCAHU Partnership • Legislative and Regulatory Advocacy • Grassroots Mobilization • Coalition Building and Collaborating to Lead Industry • Educating Policymakers, Consumers and the Media

  10. Legislative Advocacy

  11. Legislative Advocacy • S.908 (Hayes), H.4932 (Sandifer) DOI Accreditation Bill • H.3101 (Chumley) ACA Nullification • S.290 (Cleary), H.4901 (G.M. Smith) Telemedicine • S.936 (Peeler ) Air Ambulances • S.961 (Cleary), H.4510 (Ryhal) Navigator Background Checks • S. 35 (Campsen) Healthcare Sharing Ministries • S.886 (Massey)Out-of-State Health Insurers

  12. ACA Impact on SCAHP & SCAHU • FFM vs. State Exchange • Retention of Older Policies • DOI Regulatory Control • Consumer Protection Services • Navigators • Ever Changing Enforcement Rules • Current Subsidy Litigation

  13. Current South Carolina ACA Data • SC Enrollment Numbers as of March 1, 2014 • 55,830 people have enrolled in plans. Up from 24,116 in December 2013. • Of the 55, 830 enrolled, 86 percent qualified for some financial assistance in the form of tax credits based on income and family size. • Pool is older, slightly sicker than current individual pool. • Open enrollment closes March 31, 2014.

  14. FFM Stakeholders Leadership Group • Private and Public members focused on implementation in South Carolina • Practical not Political Group to Address Operational Issues • SCAHP the convening host and SCAHU is a member of the Group

  15. Leadership Group Activities • Facilitate collaboration and communication among the stakeholders to improve FFM operations • Develop the best experience for the FFM for stakeholders and consumers

  16. Progress to Date • Five General Meetings • Four Action Groups • Outreach and Education • FFM Implementation and Technology Status • Provider Network Matters • Agents, Broker, Navigator Matters • Meetings will continue through 2014

  17. SC DOI Engagement • Meetings with Director and key staff to address industry issues • Working with Department and Administration to retain state control of insurance regulation in the face of Obamacare takeover • Navigators and Agent issues

  18. Resources for SCAHU, Public and Media

  19. SCAHP Annual Health Care Conference

  20. Opportunities to Get Involved • Quarterly Meetings with speaking opportunities • SCAHP Foundation • New Members Welcome!

  21. Thank You! Jim Ritchie Executive Director SC Alliance of Health Plans jritchie@scalliance.org

  22. Legislative Advocacy • S.908 (Hayes), H.4932 (Sandifer) DOI Accreditation Bill • H.3101 (Chumley) ACA Nullification • S.290 (Cleary), H.4901 (G.M. Smith) Telemedicine • S.936 (Peeler ) Air Ambulances • S.961 (Cleary), H.4510 (Ryhal) Navigator Background Checks • S. 35 (Campsen) Healthcare Sharing Ministries • S.886 (Massey)Out-of-State Health Insurers

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