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Col
orad
o D
epar
tmen
t of H
ealth
C
are
Pol
icy
and
Fin
anci
ng
Fulfilling the Promise of Coverage
October 8, 2010
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gFocus on Systems
Improvements/State Expansions
1. What is real opportunity to fulfill the promise of coverage through systems improvements and state expansions?
2. Where do we have momentum that needs to be maintained or built upon?
3. What is going to be hard or require concerted effort to ensure our success in Colorado?
4. What is the most important thing advocates and community partners can do to ensure we fulfill the promise of coverage?
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gHealth Care Affordability Act
(09-1293): Expansion of Coverage
• May 2010: Implemented Medicaid eligibility for parents up to 100% of the FPL (24,193 Aug 2010)
• May 2010: Implemented CHP+ eligibility for children and pregnant women up to 250% of the FPL (2,018 children and 71 pregnant women Aug 2010)
• Summer 2011: Implement Medicaid Buy-In program for people with disabilities up to 450% of FPL
• Early 2012: Provide health care benefits for adults without dependent children up to 100% of FPL
• Spring 2012: Implement twelve-month continuous
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gColorado Health Insurance
StatusPre and Post Health Care
ReformCurrent (US Census - ACS)
15.80%
71.30%
22.40%
No health insurancecoverage
With private healthinsurance coverage
With public healthcoverage
• 778,000 Currently Uninsured •300,000 Obtain Insurance Exchange (Estimated)•200,000 – 250,000 Medicaid (Estimated)•250,000 Uninsured (Estimated)
Projected (2014)
5%
70%
25%
No health insurancecoverage
With private healthinsurance coverage
With public health coverage
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gThe Maze
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g Eligibility Modernization Project
• Initiated in 2008• Implement strategies that will
make the application process easier for individuals and families
• Three focus areas– Systems/Technology– Policy Changes– Business Processes
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gMobile Web Survey
• Adult laptop and cell phone internet (mobile Web) use– 2009 51%– 2010 59%
• African-Americans active use of mobile web– 2009 57%– 2010 64%
• African-Americans & English speaking Latinos ownership of cell phones v. whites (2010)– 87% - 80%
• States’ efforts lagging behind– ½ states have online enrollment for CHIP– Less than that for Medicaid– On average, 30% of new enrollments generated
onlineSource: Pew Internet and American Life Project, July 2010 http://pewinternet.org
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g Accomplishments• Implemented online self-screening tool (Am I Eligible? and
Check My Benefits) PEAK: October 2009• Application Overflow Process (April 2009)• Leveraged our Community-Based Organization
infrastructure (PE Sites, Medical Assistance Sites, Certified Application Assistance Sites)
• Legislation permitting telephonic renewal, ex-parte redeterminations
• Received HRSA State Health Access Program grant to fund outreach and eligibility modernization efforts
• New health application• Eligibility and Enrollment for Medical Assistance Programs
(EEMAP) RFP completed and contract signed with Maximus
• MORE grants ($628,790) made available to 14 community organizations
• Regional outreach and training conferences held• Colorado Eligibility Process Improvement Collaborative
(CEPIC)
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gComing
Attractions/Momentum• November 2010: Begin Vital Statistics Pilot• January 2011: Phase II of PEAK (Am I
Eligible? And Report My Changes)• 2011 – PEAK Outreach Toolkit Available• Interfaces – DRA Citizenship and Identity
Requirements– Vital Statistics– Income and Eligibility Verification System (IEVS)– Department of Revenue, Department of Motor
Vehicles– Social Security Administration
• Express Lane Eligibility• Free and Reduce Lunch • Income Tax Records
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g Challenges/Opportunities
• Budget • Transition to a new administration• CBMS: competing priorities/capacity to
implement new changes• Health care reform implementation: 2014 is
closer than we think• Transition to a new eligibility and enrollment
vendor• Securing Year 3 funding for the HRSA SHAP
grant• State/county partnership
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g Fulfilling the Promise
• Urge continuation of existing policies in the next administration
• Continued participation as Certified Application sites, Presumptive Eligibility and Medical Assistance sites
• Secure year three funding for the HRSA SHAP grant
• Continue to be passionate as we work together to ensure coverage for all Colorodans
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Sue WilliamsonExecutive Deputy Director
Colorado Department of Health Care Policy and Financing
