Pr e par ing for 2014 ACA imple me ntation E ligibility, E nr ollme nt & Re te ntion Public He alth Cove r age Public Be ne fits
PRESENTATION OVERVIEW 1. Pre pa ring fo r He a lth Ca re Re fo rm: E lig ib ility, E nro llme nt, a nd Re te ntio n 2. Curre nt Sta tus o f E lig ib ility, E nro llme nt & Re te ntio n : Ma pping 3. Ne xt ste ps in 2013: pre pa ring fo r ACA imple me nta tio n
PREPARING FOR 2014 • He a lth c o ve ra g e e lig ib ility, e nro llme nt a nd re te ntio n syste ms will c ha ng e in Ja nua ry 2014 • Ne w rule s g o ve rning e lig ib ility • Ne wly e lig ib le MC po pula tio n • E xc ha ng e • Simplifie d a pplic a tio ns a nd re ne wa ls • I ntro duc tio n o f ma jo r ne w e lig ib ility syste m • Ca lHE E Rs (CA he a lthc a re e lig ib ility, e nro llme nt a nd re te ntio n syste m)
What happens in 2014? Existing Programs After January 1, 2014 Non-MAGI* Medi-Cal, 0- • Medi-Cal (poor and: “ linkage ” = pregnant, 138% FPL with linkage + parenting, disabled, or over 65) + asset test asset test MAGI* Medi-Cal • HealthPAC Medi-Cal Coverage 0-138%FPL, citizen/LPR Expansion (MCE) “ no linkage ” Exchange • HealthPAC Health Care 138-200% FPL, citizen/LPR Coverage Initiative (HCCI) “ no linkage ” County Program • HealthPAC County (not eligible Eligibility TBD for MCE or HCCI and are between 0 and 200% of FPL) *MAGI = Modified Adjusted Gross Income 4
PREPARING FOR 2014 CONT • Ma ximize e nro llme nt in Ala me d a Co unty: 3 Ste ps • Ste p One : Ma pping o f c urre nt syste m • Ste p T wo : Ana lysis o f a lte rna tive s mo ving fo rwa rd • Ste p T hre e : I mple me nta tio n • Ove rvie w o f Ste p One : Ma pping
CURRENT STATUS: MAPPING EXERCISE • Co lla b o ra tio n b e twe e n SSA a nd HCSA • Ma p c urre nt syste m (One -e -App, He a lth-e -App, Ca lWiN, Be ne fits Ca lWIN, a nd Pa pe r Applic a tio ns) • Und e rsta nd who c a n use e a c h syste m, wha t pro g ra ms c a n b e a pplie d fo r, a nd e a se a nd use . • While it o nly d e sc rib e s a po int in time , it se rve s a s a fo und a tio n fo r e va lua ting wha t is a nd is no t wo rking .
MAPPING EXERCISE ( CONT ) • Ove rvie w o f c urre nt syste m • Sc e na rio s • F inding s
ENROLLMENT PORTALS Benefits Continuum Administered by SSA • HealthPAC County • HealthPAC LIHP MCE • HealthPAC LIHP HCCI CalFresh Health Care 400% FPL 0% FPL Coverage HCSA Indigent Programs Continuum Administered by HCSA, SSA and the Exchange • Small Employer Health Option Program (SHOP) • Individuals CalWORKS • Healthy Families (HF) Transition to the Targeted Low-Income Children’s Program (TLICP) under Medi-Cal • Access for Infants and Mothers (AIM) General Assistance (GA) • Other Medi-Cal Programs Foster care, Adoption, Pregnancy, o Disability
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