WHAT IS THE PATIENT PROTECTION AND AFFORDABLE CARE ACT? Effects on Community Level Organizations and Their Practices WHAT IS THE PATIENT PROTECTION AND AFFORDABLE CARE ACT? Quick Quiz Test Your Knowledge What do you know about the Patient Protection and Affordable Care Act? PPACA: A CLOSER LOOK The Patient Protection and Affordable Care Act (PPACA), aka Obamacare or Affordable Care Act (ACA) Signed into law March 2010 Most expansive overhaul to the U.S. Healthcare system since the Social Security Act Virginia is working aggressively to be compliant with the required aspects of the PPACA PPACA: KEY POINTS AND CHANGES ACROSS THE NATION Subsidizes health plans for small businesses and nonprofits in 2010, 2015 Standardizes health plan methods for electronic Health and Human Resources delivery in 2012 Makes consumer health information available online in 2012 Includes health insurance coverage of young adults on family plans to age 26 in 2010 Mandates individual health insurance coverage on January 2014 PPACA: KEY POINTS AND CHANGES ACROSS THE NATION Medicaid for former VA foster care youth extended to age 26 Medicaid Program assisting pregnant women has changed Designed to complement Medicaid by providing health insurance options to those who do not qualify for Medicaid benefits Establishes Health Insurance Marketplace (HIM) where people can purchase subsidized and full -cost insurance in 2014 Applications can now be taken by paper, phone, fax and on-line in 2014 PPACA: KEY POINTS AND CHANGES ACROSS THE NATION Mandates individual health insurance coverage in January 2014 Standardizes eligibility rules across all 50 states so that eligibility determinations on certain Medicaid programs can be applied consistently and efficiently from state to state in 2014 Gives states the option to expand Medicaid to all citizens at or below 133% of the federal poverty level PPACA: PREPARING THE COMMONWEALTH FOR NEW REQUIREMENTS Expanded access to benefit applications and resources through CommonHelp Smarter processing of Medicaid applications using Federal Data Hub resources On-line credentials checked electronically fighting fraud & abuse PPACA: PREPARING THE COMMONWEALTH FOR NEW REQUIREMENTS VA Medicaid Call Center for additional citizen access Electronic coordination of applications between Medicaid and the Health Insurance Marketplace (HIM) Preparing to be available October 1, 2013 COMMONWEALTH PROCEEDING WITH MEDICAID REFORM There is no current plan to expand eligibility within the Virginia Medicaid program. Governor and Legislature have agreed to undertake major reforms within the Medicaid program. The 2013 General Assembly established a legislative body to oversee reforms. PPACA: KEY POINTS AND CHANGES ACROSS THE COMMONWEALTH Looking at MAGI (Modified Adjust Gross Income) to determine eligibility New eligibility rules have allowed workers to make determinations automatically in some cases, with certain Medicaid programs CommonHelp and the new streamlined application Creates online accounts to apply for Social Service benefits Streamlined, self directed application process Works with the Health Insurance Marketplace (HIM ) to transfer citizen’s application to the FFM if they do not qualify for Medicaid TAKING A CLOSER LOOK: WHAT IS THIS HEALTH INSURANCE MARKETPLACE?