Embed Size (px)
DESCRIPTION
ACA learning session
Citation preview
Affordable Care Act (ACA) Learning Sessions for Social Sector Leaders & Community Advocates
April 12, 2013
Coordinated by the Access HealthColumbus Community Advisory Committee
Purpose Spread knowledge of federal health care reform in non-profit organizations to improve their ability to serve clients during the implementation of the Affordable Care Act (ACA). Today’s Objectives 1. Improve knowledge of how the ACA affects small employers. 2. Improve knowledge of covered benefits under ACA in Ohio. 3. Provide an update on ACA Health Benefit Exchanges and Navigators in Ohio. 4. Provide an update on Medicaid expansion and changes in Ohio. 5. Obtain input on shaping future Learning Sessions (tentatively 7/19 and 9/13).
2
Today’s agenda
9:00 Welcome & ACA Introduction – Isi Ikharebha 9:20 ACA & the Small Employer – Carol Deibel 9:45 Covered benefits under ACA in Ohio Update on Health Benefit Exchanges & Navigators -- Doug Anderson 10:15 Update on Medicaid Expansion – Jeff Biehl 10:40 Shaping Future Learning Sessions – Isi Ikharebha 10:50 Closing & Next Steps – Isi Ikharebha
Affordable Care Act
Near Universal Insurance Coverage
Guaranteed Issue &
Insurance Mandate
Improvement Initiatives
Health Benefit
Exchanges
ACA: Key Areas of Change
Affordable Care Act
Near Universal Insurance Coverage
Guaranteed Issue &
Insurance Mandate
Improvement Initiatives
Health Benefit
Exchanges
Expansion of Medicaid
Subsidized commercial
insurance for middle-income
families (market based)
11/16/12 – Ohio submitted intent for federal Health Benefit Exchange
Early 2013 – Ohio’s budget process includes the governor’s recommendation for Medicaid expansion in Ohio
June 2013 – State will finalize budget with Medicaid expansion decision
Fall 2013 – People begin to enroll through Health Benefit Exchanges
January 2014 -- • Permanent insurance reforms take effect • Low income subsidies start • Coverage through exchanges becomes
effective • Mandates take effect
o Individual Mandate o Employer Mandate
ACA and the Small Employer
7
Important Milestones for Small Businesses
Late summer/early fall 2013 – Notice to Employees
– Employers will provide employees with a notice about the availability of a health
insurance marketplace in their state. Original deadline was extended, and a specific
date has not been set. Model language for notice has also not been indicated.
July 31, 2013 - $1 to Research
– Insured and self-funded plans will pay $1/member to fund comparative effectiveness
research of medical treatments by the new non-profit Patient Centered Outcomes
Research Institute
October 1, 2014 – Marketplace/Exchange
– State’s health insurance marketplace will enroll individuals and small employers (<50
employees). Small businesses do not have to enter the marketplace until their current
coverage expires.
8
Important Milestones for Small Businesses
January 1, 2014 – Insurance purchase mandate / Benefit changes /
Reinsurance fees
• Citizens and legal residents are required to purchase minimum essential health coverage
or pay an annual individual responsibility tax.
• Employer-sponsored plans cannot impose annual benefit limits or pre-existing condition
limits.
• Deductibles in the small group insurance market (<100 employees) cannot exceed
$2,000/individual or $4,000/family.
• Employee wellness rewards can be increased from 20% to 30% of the cost for single
coverage. Incentives to 50% for plans designed to prevent/reduce tobacco use.
• State based Transitional Reinsurance Programs are established to help stabilize individual
premium. Insured and self-funded plans will be assessed fees to fund the program during
2014-2016. Fees for 2014 are estimated at $63/member (employee, spouse, or child).
9
10
Kaiser Family Foundation http://healthreform.kff.org/the-basics/employer-penalty-flowchart.aspx
11
12
Penalties for Employers Not Offering Affordable Coverage Under the Affordable Care Act Beginning in 2014 (Continued)
How are small businesses effected?
Fewer than 25 full time employees
– Eligible for tax credit if average annual wages are less than $50,000 and company
pays at least half of employees health insurance cost
– For tax years 2010 to 2013, eligible employers may receive a tax credit of up to 35%
of the employer's contribution toward the employee’s health insurance premium.
– Employers are eligible to take the tax credit for 2010-2013 and any two years after
that.
– Tax-exempt (Non-Profit)small businesses meeting these requirements are eligible for
tax credits smaller than the For-Profits.
– See your tax advisor.
25 - 49 full time employees
– Exempt from penalties faced by larger employers that do not offer coverage.
13
How are small businesses effected?
50 - 99 full-time employees
– Will be able to purchase coverage through Small Business Health Options Program
(SHOP) Exchanges beginning in 2015.
– Affordable essential health benefit coverage to substantially all (95%) of its full-time
employees and their eligible dependents
Otherwise, excise taxes may apply.
Coverage is unaffordable if:
– The employee’s required premium/contribution for self-only coverage
exceeds 9.5% of the employee’s W-2 income; or
– The insurance does not pay for at least 60% of covered health care
expenses.
– Premium subsidies are available to any employee between 100-400% FPL and whose
employer does not offer affordable coverage.
14
How will the ACA effect me?
Will I have to offer coverage?
– Businesses with less than 50 employees are not subject to penalties for not offering
coverage, or offering unaffordable coverage.
Will my coverage change?
– If you are currently covered by an insurance plan your coverage will not have to
change until your plan renews. Plans purchased after January 1, 2014 will be
required to cover essential health benefits discussed later in this presentation.
Do I have to buy my insurance through the exchange (also called SHOP
(Small Business Health Options Programs)?
– No, your coverage can still be purchased through an insurance broker (with or without
using SHOP).
– For 2014, the SHOP employer plans will not include multiple choice plans for
employees (one plan selection)
Will the new consumer protections and community rating rules change
my premium?
– These new rules could potentially increase/decrease your premium cost significantly.
15
Is my business eligible for tax credits?
• Do you pay at least half of your employee’s single coverage health
insurance premiums?
• If yes, your company may be eligible for a tax credit.
• How many full-time employees (FTEs) do you have?
• Companies with less than 10 FTEs are eligible for the full tax credit. Companies with
10–24 FTEs are eligible for a reduced credit.
• What is the average salary of your FTEs?
• Companies with average annual wages of $25,000 are eligible for full credit.
Companies with average wages up to $50,000 are eligible for partial credit.
• See your tax advisor.
16
How is the tax credit calculated? (Starting in 2014: For-Profit)
Employees ≤$25,000 $30,000 $35,000 $40,000 $45,000 $50,000 ≤10 50% 40% 30% 20% 10%
11 47% 37% 27% 17% 7%
12 43% 33% 23% 13% 3%
13 40% 30% 20% 10%
14 37% 27% 17% 7%
15 33% 23% 13% 3%
16 30% 20% 10%
17 27% 17% 7%
18 23% 13% 3%
19 20% 10%
20 17% 7%
21 13% 3%
22 10%
23 7%
24 3%
25 17
How is the tax credit calculated? (Starting in 2014: Non-Profit)
Employees ≤$25,000 $30,000 $35,000 $40,000 $45,000 $50,000 ≤10 35% 28% 21% 14% 7%
11 33% 26% 19% 12% 5%
12 30% 23% 16% 9% 2%
13 28% 21% 14% 7%
14 26% 19% 12% 5%
15 23% 16% 9% 2%
16 21% 14% 7%
17 19% 12% 5%
18 16% 9% 2%
19 14% 7%
20 12% 5%
21 9% 2%
22 7%
23 5%
24 2%
25 18
What is a full-time employee?
Employees working on average at least 30 hours/week
Employers may choose to count hours in one of three different ways:
– Actual hours of service: Divide the total hours for which the employer pays wages to
the employees during a taxable year by 2,080. No more than 2,080 hours (equivalent
to a 40-hour work week) should be counted for any employee.
– Estimate hours based on total days of service
– Estimate hours based on total weeks of service
Seasonal workers are not included unless they are employed for more than 120
days during the tax year.
Business owners and family members of business owners (excluding spouses)
employed by the business do not count as FTEs.
19
Affordable coverage for employees of small businesses
– A number of factors need to be accounted for, including: income, family
status, cost sharing, employer’s premium contribution
– Employees offered affordable coverage will not be eligible for the
exchange.
– Premium subsidies and cost-sharing assistance will not be available to the
uninsured spouses and children of employees who have access to
affordable self-only coverage but who cannot afford dependent coverage.
How much will the government provide in subsidies for
purchasing coverage through the exchange?
– http://laborcenter.berkeley.edu/healthpolicy/calculator/
– http://healthreform.kff.org/subsidycalculator.aspx?source=QL
20
• Will employer coverage be more affordable than individual
coverage purchased through the exchange for employees of
small businesses and their families?
ACA and the Small Employer
21
Summary -- 2014 brings more choice and control
• You control the coverage you offer and how much you contribute towards your employee’s coverage
• You may have additional access to tax benefits
• Benefits of new consumer protections regarding premiums
• Insurance plans will still be run by private companies
• Use your broker or shop on your own
• Exchanges, including SHOP (Small Business Health Options Program) available in October 2013
ACA and the Small Employer
Q & A
22
ACA Covered Benefits in Ohio
23
Essential Health Benefits
ACA requires items and services from the following 10 categories:
1. Ambulatory patient services
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services; including behavioral health treatment
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventative and wellness services and chronic disease management
10. Pediatric services, including oral and vision care
*Nebraska selected a unique “Nebraska Option” as its benchmark plan. This plan was not among the ten plan options outlined in federal guidance.
**Michigan selected a benchmark plan that is one of its largest small group plans and also the state’s largest commercial HMO plan.
***Maryland originally selected a state employee benefit plan but later switched to a small group plan during the HHS rulemaking process.
****States that did not select a benchmark plan will have the largest small group plan in their state as their default essential health benefits plan.
Source: Authors’ analysis.
Essential Health Benefits Benchmark Plan Selection, as of October 2012
State selected a state
employee benefit plan as
its benchmark plan
State selected the
largest commercial HMO
plan as its benchmark
plan
State selected a small
group plan as its
benchmark plan
FL
NC
SC
GA
LA TX
AL
AR
KS
OK AZ TN
MS
NV
UT
NM
CA
WY
ID
WA
OR ND
SD
NE*
MT
MO
IN
MI**
WI
IL
ME
OH
KY
HI
AK
PA
WV VA
CT NJ
DE
MD***
RI
NH
VT
DC
MA
CO
IA
NY
MN
State did not select a
benchmark plan****
25
Ohio’s Essential Health Benefits
1. Ambulatory Patient Services
• Primary care visit to treat injury or illness
• Specialist visit
• Other practitioner office visit (Nurse, Physician Assistant)
• Outpatient facility fee
• Outpatient surgery physician/Surgical services
• Urgent care centers or facilities
• Allergy treatment
2. Emergency Services
• Emergency room services
• Emergency transportation/Ambulance
3. Hospitalization
• Inpatient hospital services
• Inpatient physician and surgical services
26
Ohio’s Essential Health Benefits
4. Maternity and Newborn Care
• Prenatal and postnatal care
• Delivery and all inpatient maternity care
5. Mental Health and Substance Use Disorder Services; Including Behavioral Health Treatment
• Mental/Behavioral health outpatient services
• Mental/Behavioral health inpatient services
• Substance abuse disorder outpatient services
• Substance abuse disorder inpatient services
6. Prescription Drugs
• Generic Drugs
• Preferred brand drugs
• Non-preferred brand drugs
• Specialty Drugs
• Injectable drugs and other drugs administered in a provider’s office or other outpatient setting.
27
Ohio’s Essential Health Benefits
7. Rehabilitative and Habilitative Services and Devices
• Outpatient rehabilitation services
• Habilitation services
• Rehab facilities including room and board charges, physicians fees, imaging, testing, and inpatient hospital
services
8. Laboratory Services
• Diagnostic test (X-Ray and lab work)
• Imaging (CT/PET Scans, MRI)
9. Preventative and Wellness Services and Chronic Disease Management
• Routine eye exam (Adult)
• Chiropractic care
• Preventative care/Screening/Immunization
10. Pediatric Services, Including Oral and Vision Care
• Routine eye exam (Children)
• Eye glasses for children*
• Dental check-up for children*
*Required but not covered in benchmark plan
28
Ohio’s Essential Health Benefits
11. Additional Benefits Covered in Ohio
• Hospice services
• Private-duty nursing
• Home health care services
• Skilled nursing facility
• Durable medical equipment
• Radiation therapy
• Chemotherapy
• Infusion therapy
• Renal dialysis/Hemodialysis
• Vision correction after survey or accident
• Medical supplies, equipment, and education for diabetes care for all diabetics
• Dental services for accidental injury and other related medical services
• Human organ and tissue transplant services, and unrelated donor search
• Temporomandibular or craniomandibular joint/jaw treatment (TMJ)
29
Ohio’s Essential Health Benefits
Benefits Not Covered:
• Non-Emergency care when traveling outside the US
• Long-term/Custodial nursing home care
• Bariatric surgery
• Cosmetic surgery
• Hearing aids
• Routine foot exam
• Acupuncture
• Weight loss programs
• Routine dental services (Adult)
• Infertility treatment
30
Metal Plans
Plans offered in the individual and small group markets will have cost sharing,
including deductibles, copays and other cost sharing. Out of network services
will cost more for the consumer.
Plans must fall into metal tier which represent the extent to which the plan has
higher cost sharing or lower cost sharing.
Metal tiers represent the average an insurer will pay for covered services for all
policies issued within a metal tier.
– Bronze = The carrier pays 60% of covered benefits; the individual pays 40%
– Silver = The carrier pays 70% of covered benefits; the individual pays 30%
– Gold = The carrier pays 80% of covered benefits; the individual pays 20%
– Platinum = The carrier pays 90% of covered benefits; the individual pays 10%
Plans will also have out of pocket maximums no greater than $6,400/$12,800.
31
Catastrophic Plans
For adults under 30 and people exempt from the individual mandate,
carriers may also issue catastrophic plans, with higher cost sharing.
– Catastrophic plans provide the essential health benefits
after the insured has met a deductible which must be equal
$6,400 for and individual and $12,800 per family in 2014.
– The deductible does not apply to at least three primary care
visits.
32
ACA Covered Benefits in Ohio
Q & A
33
Exchanges & Navigators Update
34
Ohio’s Health Benefit Exchange decision, November 16, 2012
Governor John Kasich sent a letter to the director of Centers for Medicare and Medicaid Services Center for Consumer Information and Insurance Oversight to indicate Ohio’s Health Benefit Exchange decision under the Affordable Care Act.
• “Ohio will not operate a federally-mandated exchange but instead will exercise its right under the law to leave that to the federal government;”
• “Ohio will … retain the right to regulate the state’s insurance industry…”
• Ohio will retain the right to determine Medicaid and CHIP eligibility for its citizens
35
36
Key Exchange Functions in a Federally–facilitated Exchange (FFE) - Activities
In opting for a Federally Facilitated Exchange (FFE) Ohio has:
• ceded the responsibility for running the exchange to the federal government
• will retain control over Medicaid eligibility determinations
• will retain its regulatory authority over the state’s insurance markets
Consumer assistance will be available through navigators—entities that will assist consumers and small employers with the enrollment process.
Under Ohio’s FFE, the federal government will select, train and provide funding to entities participating in the navigator program.
37
Key Exchange Functions in a Federally–facilitated Exchange (FFE) - Activities
By foregoing a partnership or state-based exchange model, Ohio will not be eligible to obtain federal funds to establish and operate an optional in-person consumer assistance program, an option that acknowledges not all communities or eligible individuals will have easy access to a navigator.
38
Key Exchange Functions in a Federally–facilitated Exchange (FFE) - Activities
Health and Human Services activities for FFE:
• Developing a unified FFE infrastructure
• April 2013- Carriers will apply to become Qualified Health Plans
• September 2013- Agreements with Qualified Health Plan Issuers will be completed
• October 1, 2013- Open enrollment on exchanges for the 2014 coverage year will begin
From: General Guidance on FFEs, issued by Health and Human Services, May 16, 2012
39
Who will use the individual marketplace (exchange)?
Individuals 18-64 years old between 100-400% of the FPL who do not
receive/cannot afford employer coverage.
A national study conducted by Lake Research Partners found that:
– 52% are female.
– 84% do not have a college degree.
– 32% are currently uninsured (67% have been uninsured for 2+ years)
– 78% of uninsured adults lack awareness of new options for insurance under the
ACA.
– 22% Latino, 16% African American
– 44% have shopped for health insurance outside of their job.
– 70% say they would be very (38%) or some-what (32%) likely to go to the
[exchange] website to find and compare plans if they did not have insurance in
2014.
40
Most Important Facts for the Individual Exchange Population
1. All insurance plans will have to cover doctor visits, hospitalizations,
maternity care, emergency room care, and prescriptions.
2. You might be able to receive financial help to pay for a health
insurance plan.
3. If you have a pre-existing condition, insurance plans cannot deny you
coverage.
4. All insurance plans will have to show you the costs and what is
covered in simple language with no fine print.
41
Navigators in the ACA
Defined by the ACA
– Conduct public education activities to raise awareness of the availability
of qualified health plans
– Distribute fair and impartial information concerning enrollment in
qualified health plans, and the availability of premium tax credits and cost-
sharing reductions
– Facilitate enrollment in qualified health plans
– Provide information in a manner that is culturally and linguistically
appropriate to the needs of the population being served by the exchange
or exchanges.
– Provide referrals to the appropriate entity or agency for consumers with a
grievance, question, or complaint.
42
Navigators in Ohio
Ohio Senate Bill 9 & House Bill 3
– Enables a licensed insurance agent to sell health benefit plans offered through an
exchange and prescribes associated requirements.
– Specifies that an insurance navigator is prohibited from engaging in the act of selling
insurance and other related functions.
– Authorizes non-licensed navigators to do the following:
Conduct public education activities to raise awareness of the availability of qualified health
plans.
Distribute fair and impartial general information concerning enrollment in all qualified health
plans offered within the exchange and on the availability of premium tax credits and cost-
sharing reductions under the ACA
Facilitate enrollment in qualified health plans, without suggesting that an individual select a
particular plan.
Provide referrals to state agencies for enrollees with a grievance, complaint, or question
regarding their health plan, coverage, or a determination under such plan.
Provide information that is culturally and linguistically appropriate to the needs of the
population being served by the exchange.
43
Navigators in Ohio
Ohio Senate Bill 9 & House Bill 3 continued..
– Prohibits navigators from the following activities:
Sell, solicit, or negotiate health insurance.
Provide advice concerning the substantive benefits, terms, and
conditions of a particular health benefit plan or offer advice about
which health benefit plan is better or worse or suitable for a particular
individual or entity.
Recommend a particular health plan or advise consumers about which
health benefit plan to choose.
Provide any information or services related to health benefit plans or
other products not offered in the exchange. The bill specifies that this
provision is not to be interpreted as prohibiting an insurance navigator
from providing information on eligibility for Medicaid.
44
Navigators in Ohio
Ohio Senate Bill 9 & House Bill 3 continued..
– Sets eligibility requirements:
At least 18 years of age.
Completed and submitted the application and disclosure form
declaring any potential conflicts of interest and any other information
the Superintendent of Insurance considers pertinent.
Has successfully completed a criminal records check.
Successfully completed the insurance navigator certification and
training requirements adopted by the Superintendent.
Paid all associated fees.
45
Navigators – new CMS grants
46
CMS announces exchange navigator grants
The Centers for Medicare & Medicaid Services will accept applications through June 7 for
a portion of $54 million in funding to support “navigators” authorized by the Patient
Protection and Affordable Care Act to provide unbiased information to consumers about
coverage options in health insurance exchanges, also known as marketplaces. Letters of
intent are due by May 1.
According to CMS, the funding opportunity is open to eligible self-employed individuals and
private and public entities applying to serve as navigators in states with a federally-
facilitated or state partnership marketplace.
CMS will host calls for potential applicants on April 11 and 19 from 3:30-5 p.m. Eastern
Time to answer technical questions. To access the calls, dial 877-267-1577; ID 5119 for
the first call, and 2917 for the second.
Last week, CMS released a proposed rule outlining standards for navigators in states with
a federally-facilitated or state partnership marketplace.
From American Hospital Association news 4/9/2013
Exchanges & Navigators Update
Q & A
47
Medicaid Expansion Update
48
Medicaid Expansion Timeline
January 1, 2013:
– Increased Medicaid payments for primary care physicians goes into effect.
February 4, 2013:
– Governor Kasich includes Medicaid expansion in his two-year budget
proposal.
April 8, 2013:
– House of Representatives voted to exclude Medicaid expansion from the
Governor’s budget.
June 30, 2013:
– Deadline for Ohio legislature to decide whether or not to approve Kasich’s
budget proposal.
49
Medicaid Expansion Timeline
January 1, 2014:
– Expanded Medicaid eligibility goes into effect in states choosing to
participate.
– Affordable Insurance Exchanges open for enrollment.
– Hospitals are permitted to make presumptive Medicaid eligibility
determinations.
October 1, 2015:
– Federal matching funds for the Children’s Health Insurance Program
(CHIP) will increase up to 100%.
THERE IS NO DEADLINE FOR EXPANDING MEDICAID
50
51
Ohio Medicaid Expansion
More than 2.3 million Ohioans are enrolled in Medicaid.
In 2012, 1.36 million Ohioans were uninsured (1,229,587 adults and 139,884
children).
Currently, to qualify for Medicaid most adults must be either:
– Low-income and have a child in the family
– Or disabled
Many Ohio low-income are not eligible for coverage
The ACA and U.S. Supreme Court affords states the opportunity to extend
Medicaid coverage to address this coverage gap. 52
Ohio Office of Medical Assistance
Ohio Medicaid Expansion
To address the coverage gap for Ohioans, Governor Kasich has proposed in
his Jobs Budget 2.0 to extend Medicaid coverage to adults who have annual
incomes ≤138% of the Federal Poverty Level.
To assist Medicaid expansion, the federal government will pay for 100% of the
Medicaid coverage cost for the newly Medicaid eligible population, decreasing
to 90% by 2020.
If the federal government reduces its assistance for Medicaid expansion,
proposed budget language would revert coverage back to current eligibility
levels.
53
Ohio Office of Medical Assistance
0%
100%
200%
300%
400%
500%
Children 0-18without coverage
Parents Childless Adults Disabled Workers Other Aged, Blindand Disabled
Fed
eral
Po
vert
y Le
vel (
FPL)
Medicaid
Private Insurance $92,200*
(family of 4)
Disabled Ohioans in this income range “spend down” their income to qualify for Medicaid
$31,809* (family of 4)
Health Benefit Exchange
Optional ACA Medicaid Expansion to 138%
* The 2012 poverty threshold is $11,170 for an individual and $23,050 for a family of four.
Current Ohio Medicaid Eligibility Federal Exchange Eligibility Not Covered by Ohio Medicaid or Federal Exchange
2014 Federal Health Coverage Expansion
54
Ohio Medicaid Expansion
Additional changes in the ACA and proposed in the budget include…
A Simplified Eligibility Policy that collapses Ohio’s current 150+ Medicaid
eligibility categories into three:
1. Children and pregnant woman;
2. Individuals who are 65 years and older, who have Medicare coverage, or who need
long-term services and supports; and
3. Community adults (those not pregnant or needing long-term services).
Replacing the Medicaid Eligibility Process, enabling most potential Medicaid
enrollees to become enrolled based on data available from federal and state
sources without the need of additional eligibility tests.
Replacing the Eligibility Enrollment System with an automated system that
relieves manual data input processes. 55
Ohio Office of Medical Assistance
Ohio Medicaid Expansion
Who is caught in Ohio’s Coverage Gap?
A Individuals with income ≤138% of poverty ($15,415 for an individual or
$31,809 for a family of four).
About half in the gap work, but their employer doesn’t offer or they can’t afford
health insurance.
Many in the gap work as health care providers for others but don’t themselves
have coverage
Some in the gap are unable to work because of mental illness or addiction, but
have no regular source of care to recover.
A national study found that 83% of the Medicaid expansion population were
unaware of their eligibility status. 56
Ohio Office of Medical Assistance
Ohio Medicaid Expansion
Prior Medicaid Eligible Status
174,154 = uninsured parent with a child in the household with annual family
income ≤90% of FPL*
101,915 = uninsured children living in a household with annual family income
≤200% FPL.
*Please note that Ohio Medicaid assumes that for parents, self-reported income at 100% FPL is
representative of the current Medicaid eligibility income threshold of 90% FPL after
accounting for applicable disregards.
57
Ohio Office of Medical Assistance
Medicaid Expansion Update
Q & A
58
Feedback
Future Learning Sessions Please fill in your Blue handout
Affordable Care Act (ACA) Learning Sessions for Social Sector Leaders &
Community Advocates April 12, 2013
Coordinated by the Access
HealthColumbus Community Advisory Committee
THANK YOU!
Lead Support Major Support Additional Support
100% Access HealthColumbus
Board & Staff
Individual & Corporate Donations
60
Want to learn more about the Affordable Care Act?
We will send you links to the slides and these sources:
http://healthreform.kff.org/timeline.aspx?source=QL http://healthreform.kff.org/the-basics/Requirement-to-buy-coverage-
flowchart.aspx http://healthreform.kff.org/the-basics/employer-penalty-flowchart.aspx http://cciio.cms.gov/resources/files/FFE_Guidance_FINAL_VERSION_051612.pdf http://healthreform.kff.org/subsidycalculator.aspx http://uhcanohio.org/content/health-care-reform-0
Implementation Timeline: http://healthreform.kff.org/timeline.aspx?source
=QL http://www.medicaid.gov/AffordableCareAct/Ti
meline/Timeline.html http://www.findleydavies.com/index.php/resour
ces/health-care-reform/426-health-care-reform-path-to-compliance
Affordable Care Act slides and sources continued…
Employers: http://healthreform.kff.org/tags/employers.aspx?source=QL http://www.healthcare.gov/index.html http://healthreform.kff.org/faq/how-are-small-businesses-affected-by-health-reform.aspx http://www.sba.gov/healthcare http://www.whitehouse.gov/administration/eop/cea/Health-Care-Reform-and-Small-Businesses http://www.nfib.com/Portals/0/PDF/AllUsers/advocacy/ppaca-healthcare-law-guide-nfib.pdf http://www.smallbusinessmajority.org/hc-reform-faq/#1b http://www.bcnys.org/inside/health/2010/HealthCareSmallBusinessTaxCreditTablesApril2010%20.pdf http://www.irs.gov/uac/Small-Business-Health-Care-Tax-Credit-Questions-and-Answers:-How-to-Claim-the-
Credit http://www.irs.gov/uac/Small-Business-Health-Care-Tax-Credit-for-Small-Employers http://www.irs.gov/uac/IRS-Helps-Small-Employers-Claim-New-Health-Care-Tax-Credit%3B-Forms-and-
Additional-Guidance-Now-Available-on-Small-Business-Health-Care-Tax-Credit- http://www.healthcare.gov/marketplace/small-businesses/index.html
Essential Health Benefits: http://cciio.cms.gov/resources/files/Files2/12162011/essential_health_benefits_bulletin.pdf http://www.bcbsm.com/content/microsites/health-care-reform/en/reform-alerts/actuarial-value-
defined.html
Exchanges/Navigators: http://www.lsc.state.oh.us/analyses130/h0003-i-130.pdf http://files.www.enrollamerica.org/best-practices-institute/public-education-resources/EA_Final_Report.pdf http://www.healthreformgps.org/resources/update-when-should-uninsured-family-members-of-employees-
with-access-to-affordable-self-only-employer-coverage-qualify-for-premium-tax-credits/
