The Health Insurance Marketplace:

1. The Health Insurance Marketplace: The New Health Care Law and You

3. Two thirds of the uninsured live in 13 states Uninsured by State 67% of uninsured live in 13 states Number of Uninsured <230K 230K - 600K 600K - 1.1M 1.1M+ Source: Census Bureau, Current Population Survey, March 2011 and 2012

4. One fifth of the uninsured live in the top 13 counties and half live in the top 114 counties Uninsured by County 10% of the uninsured live in just 4 counties (LA, Harris, Cook, Miami) 20% of the uninsured live in top 13 counties (Top 4 + Next 9) 50% live in the top 114 counties (3.8% of total counties in the US)

5. Need to Inform, Educate and Assist with Enrollment The Health Insurance Marketplace 101

6. Looking at the Model by Zip Code(Source: Enroll America)

7. The Health Insurance Marketplace • A new way to get health insurance • Enrollment starts October 1, 2013 • Coverage begins January 2014 • About 25 million Americans will have access to quality health insurance • Up to 20 million may qualify for help to make it more affordable • Working families can get help through the Marketplace The Health Insurance Marketplace 101

8. All Qualified Health Plans Will Cover These Essential Health Benefits • Ambulatory patient services • Emergency services • Hospitalization • Maternity and newborn care • Mental health and substance use disorder services, including behavioral health treatment • Prescription drugs • Rehabilitative and habilitative services and devices • Laboratory services • Preventive and wellness services and chronic disease management • Pediatric services, including oral and vision care The Health Insurance Marketplace 101

9. The Law Makes Health Insurance More AffordableIn many cases, you can get preventive services for free: • Cancer screenings such as mammograms & colonoscopies • Vaccinations such as flu, mumps & measles • Blood pressure screening • Cholesterol screening • Tobacco cessation counseling and interventions • Birth control • Depression screening • And more… Visit www.healthcare.gov/prevention for a full list.

10. Eligibility and Enrollment • Marketplace initial open enrollment period starts October 1, 2013 and ends March 31, 2014 • Marketplace eligibility requires consumers to • Live in its service area, and • Be a U.S. citizen or national, or • Be a non-citizen who is lawfully present in the U.S. for the entire period for which enrollment is sought • Not be incarcerated The Health Insurance Marketplace 101

11. Application and Eligibility Eligible for Marketplace or Medicaid/CHIP Enroll (Marketplace) Screen (Medicaid/CHIP) • Online • Phone • Mail • In Person Supported by Data Services Hub The Health Insurance Marketplace 101

12. Assistance – It’s Available If You Need It • Help will be available in the Marketplace • Toll-free call center - 24/7Federal Call Center is up and running and the number is: 1-800-318-2596.   • 150 languages • Website chat 24/7 (English and Spanish) • Help in-person • Navigators • Other trained enrollment assisters • Local Community Health Centers, libraries, hospitals and other locations in local communities • Agents and brokers The Health Insurance Marketplace 101

13. Help to Pay Qualified Health Plan Costs • Based on family income and size • Premium discount • Family of four with annual income $23,550* – $94,200* or less • And not eligible for certain other insurance coverage like Medicaid • Lower cost-sharing (like copays) • Family of 4 with annual income $58,875* or less (some other restrictions) *2013 amounts The Health Insurance Marketplace 101

15. www.HealthCare.gov Now - Sign up for Email and Text Alerts and Get Ready Starting October 1, 2013, you will be able to apply through this site The Health Insurance Marketplace 101

16. Marketplace.cms.gov Get the latest resources to help people apply, enroll, and get coverage in 2014 The Health Insurance Marketplace 101

17. Arizona Provider Website www.coveraz.org

18. ACA Requirements for States

19. New Application and Eligibility System Health-e-Arizona Plus

20. Between Arizona and the Federally Facilitated Marketplace, Consumers Have a Wide Range of Program Options

21. Many Programs are Accessed Through Health-e-Arizona Plus Start Here Health-e-Arizona Plus FFM Referral to FFM Link to FFM Apply for SNAP = Supplemental Nutrition Assistance Program (Nutrition Assistance) TANF = Temporary Assistance for Needy Families (Cash Assistance) Clinic SFS = Clinic-based Sliding Fee Scale programs County CAP = County-based Community Assistance Programs (CAP)(Pima and Santa Cruz Counties) PTC = Premium Tax Credit Program CSR= Cost Sharing Reduction Program SHOP = Small Business Health Opportunities Program

22. Applications Started at the FFM Start Here Health-e-Arizona Plus FFM No Access Assessment Apply for SNAP = Supplemental Nutrition Assistance Program (Nutrition Assistance) TANF = Temporary Assistance for Needy Families (Cash Assistance) Clinic SFS = Clinic-based Sliding Fee Scale programs County CAP = County-based Community Assistance Programs (CAP)(Pima and Santa Cruz Counties) PTC = Premium Tax Credit Program CSR= Cost Sharing Reduction Program SHOP = Small Business Health Opportunities Program

23. Integration with FFM

24. Arizona Wants to Avoid Consumer Confusion ? Federally Facilitated Marketplace ? HEAplus ?

25. Upcoming Milestones

26. What is the MIHS Plan? • Focus on Micro-targeting • Collaborate with VISTA and AmeriCorp Volunteers • Develop Matrix of Leads within Clinics or Areas of the Hospital • Create and/or Distribute Informational Materials • Created www@aca.mihs • Created SharedGroup Folder: ACA

27. What is the MIHS Plan? • Training staff on how to help customers by: • Identify those who will benefit • Inform them of the programs (Medicaid Expansion and Marketplace) • Educate patient (Family Learning Centers) • Refer patients (Consumer Assisters, Brokers, Agents and Navigators) • Enroll (HEA Plus or FFM) • Explore scheduling enrollment events The Health Insurance Marketplace 101

28. For More Information 1. Contact your Medical Provider or Case Manager 2. Visit www.healthcare.gov Visit www.CuidadoDeSalud.gov 3. Health Insurance Marketplace Toll-free Call Center Available 24/7 1-800-318-2596 TTY: 1-855-889-4325 4. Contact our Family Learning Center Staff at 602-344-1352 5. E-mail MIHS at aca@mihs.org

29. Acknowledgements This presentation is a compilation of many sources including: • Center for Medicare and Medicaid Services, The Health Insurance Marketplace (July 2013) • Census Bureau, Current Population Survey, (March 2011 and 2012) • Enroll America • Kaiser Family Foundation, Tracking Poll (April 2013) • Arizona Health Care Cost Containment System Administration (May 2013) • Arizona Alliance for Community Health Centers (July 2013)