Eff ects 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?

WHAT IS 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

Subsidizes health plans for small businesses and non-profi ts 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 benefi ts

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 effi ciently 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: KEY POINTS AND CHANGES ACROSS THE NATION

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

PPACA: PREPARING THE COMMONWEALTH FOR NEW

REQUIREMENTS

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.

COMMONWEALTH PROCEEDING WITH MEDICAID REFORM

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

PPACA: KEY POINTS AND CHANGES ACROSS THE COMMONWEALTH

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?