Webinar health reform in florida and the impact on


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Webinar health reform in florida and the impact on

  1. 1. Health reform in Florida and the impact onits children Thursday, December 6 11:45 am to 12:30 pm Log in: https://cc.readytalk.com/partlogin/8542yrj0398u Call-in Audio: 800.931.6361
  2. 2.  Introduction Children’s coverage and the ACA – Joan Alker, Georgetown University Center for Children and Families 2012-2013 Opportunities and Goals for Child Health Advocacy– Diana Ragbeer, The Children’s Trust of Miami Dade Q&AToday’s program
  3. 3. How is Florida doing in covering kids? Joan Alker
  4. 4. Uninsured Children in Florida Percent of 2011 State Number of 2011 State Uninsured Ranking in Uninsured Ranking in Children Percent of Children Number of Uninsured Uninsured Children ChildrenFlorida 11.9% 48th 475,112 49thNational 7.5% -- 5,527,657 --
  5. 5. Florida – 3rd in Percentage PointChange of Uninsured Children 2009-2011 Percentage Rank 2009-2011 Point Change Percentage Point ChangeUnited States -1.1 -Florida -2.9 3 Source: “Uninsured Children 2009-2011: Charting the Nation’s Progress” Georgetown Center for Children and Families, October 2012.
  6. 6. Florida vs. Neighboring states:Rate of uninsured children in 2011Florida 11.9%Alabama 5.3%Georgia 9.5%Louisiana 5.8%South Carolina 8.4%
  7. 7. What are the key issues for kids in the ACA? Joan Alker
  8. 8. Children’s Coverage in Florida,2014
  9. 9. Key ACA issues for children•Maintenance of effort which prohibits states fromrolling back eligibility for adults until 2014; children2019.•This includes proposals to make it harder forpeople to enroll such as premiums or other ways inwhich a state might add “red tape.”
  10. 10. Key ACA issues for children•Alignment of eligibility for children below 133%FPL i.e. “stairstep kids”.•Intersection between Exchange andMedicaid/Healthy Kids with respect to enrollmentpractices•Extending Medicaid coverage for parents andother adults •Moving to family based coverage
  11. 11. Policy and Procedural ChangesUnder ACA•No wrong door – coverage is coordinated regardless ofpoint of entry•Multiple paths to enrollment, renewal, reportingchanges – online, phone, in-person, mail•Eligibility – data-driven, technology-enabled, real-time•Automated renewals using available data•Navigators and enhanced consumer assistance
  12. 12. Current Eligibility Levels
  13. 13. How many Floridians would gaincoverage?•We estimate that 815,000 to 1,270,000 adultsand children would gain coverage if the stateextended Medicaid to parents and other adultsbelow 133% FPL Joan Alker
  14. 14. Why would children get coverage?•Coverage is being extended for parentsand adults – the “newly eligible”•But we know that more current eligibleswill get enrolled as a result of the “welcomemat” effect. Most of these “eligible butunenrolled” will be children.
  15. 15. Different federal matching ratesapply•“Newly eligible” are funded at 100% federal costfor FY2014-2016; tapers down to 90% over thenext seven years;•Current eligibles get regular Medicaid match rate(58%) or CHIP match rate (71%)•Participation rates are likely to go up even withoutMedicaid extension because of new “culture ofcoverage”
  16. 16. Who Will remain uncovered w/obroader Medicaid coverage?
  17. 17. New Medicaid enrollment ifchanges occur Adults Adults Children newly currently currently Total eligible for eligible for eligible for Medicaid Medicaid MedicaidTotal uninsured 1,295,000 257,000 500,000 2,052,000Projected take-up rate 57% 10% 10%(low assumption)Number projected togain Medicaid 740,000 25,000 50,000 815,000coverage(low assumption)Projected take-up rate 75% 40% 40%(high assumption)Number projected togain Medicaid 970,000 100,000 200,000 1,270,000coverage(high assumption)
  18. 18. Bottom line•Florida incurs few costs for adults newlyeligible for Medicaid, slightly higher costs fornew enrollment by those already eligible.•But savings due to more coverage shouldmore than offset costs.•New coverage has positive effects for healthand quality of life
  19. 19. 2012-2013Opportunities and Goals for Child Health Advocacy Diana Ragbeer
  20. 20. Alignment withCHIPRA/ContinuationOpportunities•Extend coverage to all children who are eligibleand qualify for the enhanced federal match underprovisions of the Children’s Health InsuranceProgram Reauthorization Act (CHIPRA).• Reinstate and implement presumptive eligibilityfor all Florida KidCare program components.
  21. 21. Alignment withCHIPRA/ContinuationOpportunities•Implement 12-month continuous eligibility topromote health outcomes and quality of care forchildren enrolled in all Florida KidCare programcomponents. (Currently, children ages 6-19 withincomes below the poverty level are excluded whilemore moderate-income children of the same agequalify).
  22. 22. Administrative Efforts•Implement “express lane eligibility” in KidCare toexpedite enrollment by using information fromother public programs (such as school district freeand reduced lunch data)
  23. 23. Affordable Care Act• Ensure that all adults who are newly eligible forMedicaid under the Patient Protection and AffordableCare Act (up to 138% of the federal poverty level) areextended coverage under Florida law. (When parentsgain coverage, children gain coverage, and economicsecurity for the entire family is improved) Diana Ragbeer
  24. 24. Affordable Care ActAlignment with Changesin Federal LawFlorida must revise state statue and/or regulations to ensurecompliance with federal law in these areas:•Align Medicaid coverage to 138% of the federal povertylevel for children of all ages. Shifting children fromHealthy Kids to Medicaid will keep children in the samefamily in the same program, thereby improvingadministrative efficiency•Increase Medicaid reimbursement rates for primarycare providers to assure access to care, drawing down100% federal funding to boost rates to Medicare levels
  25. 25. Affordable Care ActAlignment with Changesin Federal LawFlorida must revise state statue and/or regulations to ensurecompliance with federal law in these areas:•Ensure that federal funds are appropriated toimplement the “no wrong door” state law that requiresFlorida to upgrade, coordinate and increase theefficiency of enrollment and eligibility systems.
  26. 26. More information Joan Alker jca25@georgetown.edu ccf.georgetown.edu www.theccfblog.org/ Diana Ragbeer diana@thechildrenstrust.org www.thechildrenstrust.org
  27. 27. Thanks for joining us! www.kidswellflorida.org info@kidswellflorida.org