+ Health Care Reform & Homeless Populations: What Does the - - PowerPoint PPT Presentation

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Barbara DiPietro

National HCH Council Policy Director

Joseph Benson

SEARCH Group Volunteer and Community Outreach, Houston, TX Member at Large, National Consumer Advisory Board

Health Care Reform & Homeless Populations:

What Does the Law Do for You?

May 9, 2012

+ Goals of Health Reform

n Increase access to health care services n Improve health of people and communities n Lower costs to individuals & families n Reduce total spending for U.S. health care n Improve quality of care for everyone

Health Care & Housing Are Human Rights

+ The Affordable Care Act (ACA)

n Signed into law in March 2010 n Major Components:

n Medicaid expansion: public health insurance

for the poor

n New health insurance rules n Help for higher income people to buy private

insurance

n Money for new health care jobs n Many other programs to improve care, lower costs

and test new ideas

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+ Current Status of the Law

n Biggest changes not until 2014 n Many people confused about law

n Lots of mixed messages and misinformation

n Obama Administration: Full speed ahead n Congress: Many trying to block and repeal n Courts: Supreme Court hearings in March;

decision expected end-June

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Health Care & Housing Are Human Rights

Medicaid Expansion: Who Is Eligible?

n Currently eligible: children, pregnant women, disabled

people, and some parents of children

n Newly eligible (starting January 1, 2014): Law expands

Medicaid to most poor people. Annual income must be below:

n About $15,000/year for singles n About $25,500/year for family of 3

n Must be a U.S. citizen or legal resident here for at least 5 years n Your state might have started expanding Medicaid already

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Medicaid Will Serve More People

n Note:

Your state may not call it “Medicaid” or may have smaller program

n Medicaid has 60 million people now (1 in 5 people) n Expansion adds 16-20 million new people nationally

(depending on outreach and enrollment)

n After expansion, about 80 million people will have

Medicaid (about 1 in 4 people)

n Largest benefit in health reform law for low-income

people

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Other Health Care Programs

n Medicare:

n Doesn’t change eligibility n Free preventive services n Law changes things “behind the scenes” n Patients should notice few changes

n VA:

n Doesn’t change

VA and TRICARE insurance

n Some people could be eligible for other programs also n If you have served in the military, make sure you get

connected to VA services!

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Signing up for Medicaid will be easier

n Law requires fast, simple process n Paper documentation will not be needed

n Do not need: paper copy of your paycheck or utility bill,

birth certificate, ID or social security card (unless there’s a

problem)

n Will need to know: your full legal name, your social

security number, your birth date, and your income

+ Using Technology to Make it Easier

n

Eligibility will be just based on your income

n

Not whether you have children or a disability

n

Not whether you have a bank account, or the value of your car, or other “assets” you might have

n

The Medicaid system will automatically verify your income with the Internal Revenue Service (IRS).

n

The Medicaid system will automatically verify your identity and your citizenship/residency status with Social Security.

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Applying for the new Medicaid

n Online applications (but can also do by phone and mail) n Do not need a permanent address and do not need to

prove residency in your state.

n “No fixed address” will be an option

n No in-person interviews n Simple renewal process, only need to renew once a year

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Benefits: Covering the Basics

n Hospital and emergency room n Prescription drugs n Doctors visits n Treatment for mental health and addictions n Lab work and other tests n Dental and vision for children only n Prevention services

Details will be different in every state

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Signing Up for a Doctor/Provider

n You will have to choose a doctor/provider n Choose your doctor carefully (don’t skip this section or you will

be “auto-assigned” somewhere!).

n This will be your “health home.” n Things to consider:

n Current provider? Transportation? Hours open? Services

needed?

n Recommendations:

n Ask your case manager for advice n Choose a health center, or Health Care for the Homeless provider

+ Those Remaining Uninsured

n Law does not provide a “right to health care” n Estimate over 20 million left uninsured

n Medicaid eligible (but not enrolled): 8-10 million n Undocumented persons: 6-7 million

n Individual Mandate: requires most people to get

health insurance or face a penalty.

n Medicaid counts toward the mandate n Penalty: $95 in 2014, $695 in 2016 — BUT… n Those not filing taxes are exempt from the penalty n If you earn less than ~$10,000 per year (2012)

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Work at State Level

n Building a new system n Making sure it all works together n Deciding details of benefits n Finding new providers n Changing the culture of “Medicaid”

+ Unresolved Questions

n How will Supreme Court

decisions determine future of all these changes?

n How will states find and enroll

everyone eligible for Medicaid?

n How will states decide the

specifics of benefits covered through Medicaid?

n How much will co-pays cost for

patients?

Health Care & Housing Are Human Rights

+ Action Steps: What to do NOW

n Spread the word: Tell friends and family about Medicaid

expansion—make sure they know to sign up in 2014

n Start planning: Talk to your doctor/provider/case manager

n Ask about tests, surgery or other care you need

n Tell your story: Decisions being made now

n Public meetings n Letter/email campaigns n Advocacy groups

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+ Action Steps: What to do NOW

n Types of decisions you can help with:

n How the system can work best for you n Types of services needed n Care for remaining uninsured n Doing outreach to find people n Help enrolling for those who need it

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+ You Don’t Have to Do it Alone!

n Many organizations can help you:

n Local Consumer Advisory Boards (CABs) (check with your

local clinic)

n National Consumer Advisory Board (ncab@nhchc.org) n Staff and other consumers from your local clinic (ask your

case manager)

n Other community groups (poverty, homelessness, health,

faith, etc. organizations)

n Groups with real life experience are very powerful

and can support each other

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+ More Information

n The National Health Care for the Homeless Council is an

• rganization trying to improve the health of homeless

people and to prevent & end homelessness: www.nhchc.org

n Join us! Free individual memberships n Health reform information: www.healthcare.gov n Health Reform Fact Sheet available online n National Consumer Advisory Board (NCAB):

ncab@nhchc.org

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+ Ultimate Goals

n Greater access to Medicaid = people

getting health care services

n More health care services = better

health

n Better health = preventing and ending

homelessness

Health Care & Housing Are Human Rights

+ Group Discussion Where

You Are

n How can you help get the word out in your community? n Do you have a story to tell that might help make the new

system work better?

n How can consumers of homeless services in your

community participate in decisionmaking?

Health Care & Housing Are Human Rights