The Patient Protection and
Affordable Care Act
Young Adult Outreach and Education
Who Doesn’t Have Insurance?
 19.7% of residents in
California lack insurance
 15.7% of residents in the
U.S. lack insurance
 32.3% of 18-34 year olds
in California lack
insurance
 26.9% of 18-34 year olds
in the US lack insurance
Who are Young Invincibles?
Overview
 What’s already in place
 What’s coming
 Health care and
undocumented immigrants
 Young adult outreach
ACA Provisions Already in Effect
that Help Young Adults
What’s Already in Effect








Dependent Coverage
Free Preventive Care
No denial for pre-existing condition for under 19
Student Health Plans
Women’s Health
Domestic Violence Support
Contraception
Community Health Centers
Dependent Coverage and
Preventive Care
 Under 26 can stay on
parent’s plan
 Under 19 – no denial for preexisting conditions
 Free Preventive Care – no
co-pays on screenings and
check-ups
Student Health Plans
 Previously limited
regulations
 Now subject to standardized
ACA requirements
 Must include preventive
care benefits
 80/20 Ratio
Women’s Health Benefits
 Well-women visits
 Support for breastfeeding
 Domestic violence screening
and counseling
 Mammograms and cancer
screenings
Domestic Violence Provisions in
the ACA
 Aug. 2012: New plans must cover
screenings and counseling for domestic
violence with no cost-sharing
 Jan. 2014: No denial of coverage for
victims of domestic or sexual assault
 Law provides $1.5 billion over 5 years
for home visitation models
 Funds for youth and teen programs on
violence prevention and healthy
relationship training
Contraception
 As of Aug 2012, new health
insurance plans must cover
contraception with no co-pay
 Religious institutions exempt
 Religiously-affiliated
institutions get 1 year delay
 After Aug. 2013, employees and
students get coverage directly
from insurance companies
Growth of Community Health
Centers (CHCs)
 Currently 8,000 CHCs provide care to
20 million individuals
 In June 2012 grants went to 219 CHCs
around the country
 Increased number of patients served
by 1.25 million
What Changes Will Come in 2014?
Changes to Come
 Medicaid Expansion
 Subsidies
 Exchanges/Marketplaces
 Individual Mandate
California and Medi-Cal
Currently may be eligible:
 Enrollees of SSI/SSP, CalWorks (AFDC),
Refugee Assistance, Foster Care or
Adoption Assistance Program
 Certain individuals under 21, 65 or older
 Blind or disabled individuals
 Pregnant women
Eligible in 2014:
 EVERYONE at or below 133% of FPL
Changes for Americans with
Disabilities
 Expands and supports the Money Follows
the Person program through 2016
 Helps states create home and communitybased services through improved
Medicaid
 Improves data collection on health
disparities and improved training and
culture competency for health care
providers
 In 2014, no annual limits, no denying
coverage for pre-existing conditions
Subsidies/Tax Credits
 Those making 133-400 % of the
federal poverty level (FPL) will
qualify for subsidies (tax credits) to
buy insurance on the exchange
 133% of FPL for 1 person is $14,900
 400% of FPL for 1 person is $44,000
How Much of a Subsidy?
• Four tiers of plans – Bronze, Silver, Gold, and Platinum
• Subsidies are calculated based on Silver plan
• Individuals can use subsidy for any plan
FPL
Income
Premium
Tax Credit Actual Cost
133%
$1,275
$283
$244
$39
250%
$2,397
$283
$90
$193
Ex-cha-cha-cha-Changes
 Shop for insurance
 Each state is different, some
will have federally-facilitated
exchanges (FFEs)
 Subsidies applied directly
Other important parts of the ACA
 Catastrophic plans
 Young adults (under 30)
and those with financial
hardship eligible
 No Annual Limits in 2014
(already phasing out)
 Tax Credit for employers
(already started)
Picture Source: http://wymancenter.org/the-importance-of-bulking-up-the-muscle-of-perseverance/
How many young people in California could
get health insurance?
Source: Census Bureau, CPS 2010
Exchanges in the States
Picture Source: Kaiser Family Foundation, Last updated November 14, 2012
California Health Benefit Exchange
 Created in 2010
 Five-member board unaffiliated with other interest groups
 Minimum requirements for insurance providers to join the
exchange
 Must offer at least one choice at each of the four levels
 Carriers that do not participate in the exchange may not sell
catastrophic-only plans.
Individual Mandate and Penalties
 Individuals must have
qualifying health
insurance
 If not, penalties
 $95 the first year
 Rises in 2016, ex. $695
 Exemptions
Picture Source: http://thepinkleague.com/2012/08/30/so-whats-the-lowdown-the-basics-of-football-part-2/
Jessica, 23 years old
 Part-time student, part-time job
 $10,000/year before taxes ~ 87%
of poverty
 Qualifies for Medi-Cal
Jeff, 22 years old
 Part-time student, full-time
construction worker
 Earns $23,000/year
 Takes home: $1,438/month
 Total health premium:
$283/month
 With tax credits he pays:
$121/month
Summary: ACA and Young Adults
 Young adults have high rates of uninsurance
 Many provisions in the ACA that help young adults
 Dependent Coverage
 Student Health Plans
 Contraception and Women’s Health
 Changes to come




Expanded Medicaid
Subsidies
Exchanges
Individual Mandate
Health Care for
Undocumented Immigrants
Medi-Cal for Undocumented
Immigrants
 Undocumented immigrants who are not eligible for full
scope Medi-Cal can qualify for Emergency Medi-Cal as
long as they meet requirements
 Services include:





Breast and cervical cancer treatment
Kidney dialysis
Family Planning, access, care and treatment
Child health and disability prevention
Access for infants and mothers
ACA Expansion and Medi-Cal
 The ACA does not cover undocumented immigrants
 Medi-Cal could expand by 30% in the next few years
 The state expects to enroll 1.5 million or more adults
in Medi-Cal as 2014 reforms occur
 There are concerns over cuts in the reimbursement
rates for providers
Outreach and
Education for Young
Adults in California
Overview
 Health Care Outreach
 Mobile Technology
 Social Media
 Challenges
 Navigators
 Timeline
Health Care Outreach
 Traditional Outreach
 Tabling
 Group presentations
 Hosting events
 New Outreach
Strategies
Mobile Outreach
 Your Healthcare Finder
 Find doctors in the area
 For Android and iPhone
 Mobile Website
 Text Message Services
 QR Codes
 Can be scanned and direct users
to your website
Find a Doctor
 Find doctors and
Community Health Centers
in your area
 Search by location with GPS
or zip code
 Search by name or category
 Shows user ratings of
doctors in the area
Healthcare FAQ
 Explains how to find health
insurance for different people
(students, chronic conditions,
buying your own plan)
 Explains the health care law
 Defines common health
insurance terms
Waiting Room Game
Fun game for people to play while passing time in the
waiting room
Using Social Media
 Facebook
 Create events
 Send news updates
 Twitter




Picture Source: Wikimedia Commons
Connect with new people
Coordinate plans
Retweet
Be fun!
Challenges
 It’s expensive
 ACA offers new options
 I’m young and healthy
 Injuries can happen to anyone
 Make it personal
 Why do I need health insurance?
 Uninsured drives up health care
costs
 Individual mandate requires
insurance
Navigators & Assisters
 State exchanges – formal
“Navigator” program
 Funded through State’s
Exchange
 Aids with outreach and
enrollment
 States with federal exchanges –
Assisters will provide help on
outreach
California’s Assisters Program
Recommendations:
Certified Enrollment
Assisters (Navigators)
 Compensated by the
Exchange
 Non-profit organizations,
community clinics,
County Social Services
offices employing
Eligibility Workers, and
labor unions.
Direct Benefit Assistors
 Not be paid by the
Exchange
 Health insurance agents,
hospitals, and providers.
Timeline: What to Look For
 Present – end of 2012:
 Educate young adults about ACA
 Ensure eligible young adults are on
dependent coverage
 Jan 2013 – Oct 2013:
 Educate young adults about the upcoming
Exchanges.
 Oct 1st, 2013 – March 31st, 2014
 Open enrollment for exchanges
 Ensure young adults are getting subsidies
and Medicaid, if possible
Key Takeaways
 ACA is phasing in, some
changes already underway
 Outreach and education
 Traditional outreach
 Social media and mobile
technology
 Big changes in 2013
 Like us on Facebook
 Follow us on Twitter
@YI_Care