Embed Size (px)
Citation preview
The Affordable Care Act:Highlights & Updates
Presentation for the Iowa State Association of Counties Meeting
November 29, 2012
Overview of the Affordable Care Act• Title I – Quality, Affordable Health Care for All Americans• Title II – Role of Public Programs• Title III – Improving the Quality and Efficiency of Health Care• Title IV – Prevention of Chronic Disease and Improving Public
Health • Title V – Health Care Workforce• Title VI – Transparency and Program Integrity• Title VII – Improving Access to Innovative Medical Therapies• Title VIII – CLASS Act• Title IX – Revenue Provisions• Title X – Strengthening Quality, Affordable Health Care for All
Americans
Restoring the Partnership for American Health:
Counties in a 21st Century Health System
• Coverage• Public Health, Prevention & Wellness• Maintaining a Safety Net• Delivery Systems & Access• Health Workforce• Health IT• Long Term Care• Jail Health
Coverage Expansion• Insurance market reforms (many began in the
first plan year after 9/23/10)• Rescissions forbidden• No lifetime caps on essential health benefits• No pre-existing condition exclusions for children
under 19• Annual limit restrictions• Dependent coverage up to age 26
• Pre-Existing Condition Insurance Plan (2010)• Larger changes in 2014
– Medicaid expansion– Health insurance exchanges– Individual & employer responsibility
Public Health:Disease Prevention & Health
Promotion• National Prevention, Health Promotion and Public
Health Council – Strategy & Reports to Congress• Prevention and Public Health Fund
– Totaling $15B over 10 years– Community Transformation Grants and grants to support
other prevention and wellness & public health activities
• Clinical and Community Preventive Services Task Forces
• Education and outreach campaigns• Preventive services in Medicaid and Medicare
Delivery Systems & Access
• $11B for Community Health Centers• $1.5B National Health Service Corps• Negotiated rulemaking committee• Medicaid = Medicare rate for primary
care docs 2013 and 2014• Medicare & Medicaid payment reforms• Care coordination efforts
– Office in CMS to improve care for dual eligibles
– Center for Medicare & Medicaid Innovation
Health Workforce
• National Health Care Workforce Commission
• Graduate Medical Education• Training programs, scholarships and
loan repayment • National Health Service Corps
Health IT
• Implement secure and interoperable electronic health records
• HITECH Act• Development of standards & protocols
to promote the interoperability of systems for enrollment in federal and state health & human services programs
Long Term Care
• Medicaid Money Follows the Person Rebalancing Demo through September 2016
• Community First Choice Option in Medicaid
Jail Health
• Persons in custody pending disposition of charges retain eligibility for coverage under plans on the exchanges
• NACo publication: County Jails and the Affordable Care Act: Enrolling Eligible Individuals in Health Coverage
Medicaid & the Safety Net
• Medicaid coverage for all up to 133% FPL– Though SCOTUS decision affects
implementation
• 100% FMAP in 2014, 90% FMAP in 2020 for expansion population
• Pass through for counties required to contribute to the non-federal share
• $14.1 Billion cuts to DSH from 2014 to 2019• New requirements for private non-profit
hospitals
Supreme Court Decision on the ACA
• SCOTUS examined four questions:– Is the individual mandate/minimum coverage
requirement constitutional?– If the individual mandate/minimum coverage
requirement is unconstitutional can it be severed from the ACA?
– Does the Anti-Injunction Act bar consideration of the individual mandate/minimum coverage provision?
– Are the Medicaid provisions coercive to states?
Source: The Advisory Board, as of 11/19/12
• ddSource: Kaiser Family Foundation
Other ACA Implementation Issues
• Release of additional regulations• Changes to the law still possible• Fiscal cliff “grand bargain”—possible
Medicaid & other changes
NACo Health Reform Implementation Activities
• Member communication• Online resources & conference
workshops• Intergovernmental activities
For more information, visit: www.naco.org/healthreformimplement
Email [email protected] to:•Sign up for NACo health reform implementation email updates•Get answers to your health reform implementation questions
For information about NACo’s Healthy Counties Initiative, visit:www.naco.org/healthycountiesinitiative
Anita CardwellProgram Manager
