Affordable Care Act: What Public Policy Leaders Should Know and Do - Paul Beddoe


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NACo Deputy Legislative Director of Health Paul Beddoe discusses what public policy leaders should know and do about the Affordable Care Act during a North Carolina Association of County Commissioners seminar held Oct. 15, 2013, in Orange County, N.C.

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Affordable Care Act: What Public Policy Leaders Should Know and Do - Paul Beddoe

  1. 1. County Commissioners and Managers: What Public Policy Leaders Should Know & Do NCACC Affordable Care Act Seminar Orange County/Chapel Hill October 15, 2013
  2. 2. Presentation Overview About NACo The Context – Why health reform? How did we end up with the ACA? County policy options under the ACA Coverage expansion Medicaid & the Safety Net Public Health: Disease Prevention & Health Promotion Jail Health WWW.NACO.ORG | MAY 2013
  3. 3. About NACo The National Association of Counties (NACo) assists America's counties in pursuing excellence in public service by advancing sound public policies, promoting county solutions and innovations, fostering intergovernmental and publicprivate collaboration and providing value-added services to save counties and taxpayers money Founded in 1935, NACo provides the elected and appointed leaders from the nation's 3,069 counties with the knowledge, skills and tools necessary to provide fiscally-responsible, quality-driven, and results-oriented policies and services for healthy, vibrant, safe and resilient counties WWW.NACO.ORG | MAY 2013
  4. 4. The Context Counties: “Where the Rubber Meets the Road” Unique Role of Counties: Providers, Payers, Purchasers Highly polarized political debate WWW.NACO.ORG | MAY 2013
  5. 5. The Context WWW.NACO.ORG | May 2013
  6. 6. The Context WWW.NACO.ORG | May 2013
  7. 7. The Context WWW.NACO.ORG | May 2013
  8. 8. The Context WWW.NACO.ORG | May 2013
  9. 9. The Context WWW.NACO.ORG | May 2013
  10. 10. NACo and Health Reform 2008 – NACo President appoints Health System Reform Working Group Working Group holds three hearings around the country Working Group drafts a White Paper proposing NACo priorities in health reform The White Paper is debated, amended and approved by the NACo Health Steering Committee, NACo Board and NACo Membership WWW.NACO.ORG | May 2013
  11. 11. County Policy Options Coverage expansion Individual mandate Define role for county agencies Community leadership role Employer mandate Set county employee health benefit policy If continuing to offer coverage, design benefit to comply with ACA Consider workplace wellness incentives WWW.NACO.ORG | May 2013
  12. 12. County Policy Options Medicaid & the Safety Net Medicaid for all up to 133% FPL – state option Pass through for counties required to contribute to nonfederal share $14.1 billion cuts to DSH 2014-2019, cuts extended into out years New requirements for NFP hospitals WWW.NACO.ORG | May 2013
  13. 13. County Policy Options Public Health: Disease Prevention & Health Promotion Prevention & Public Health Fund: “… to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs” Source: Sarah Kliff Workblog.washingtonpost WWW.NACO.ORG | May 2013
  14. 14. County Policy Options Public Health: Disease Prevention & Health Promotion, cont’d. Community Transformation Grants (CTG) Public Health Workforce Public Health Improvement Initiative (PHII) Section 317 Immunization Program Epidemiology and Lab Capacity (ELC) Grant Program WWW.NACO.ORG | May 2013
  15. 15. County Policy Options Jail Health Persons in custody pending disposition of charges retain eligibility for QHP coverage on the exchanges Screen inmates for eligibility? Enroll? Pursue billing for services? Medicaid? We’re working on it … WWW.NACO.ORG | May 2013
  16. 16. Questions? Contact Us! For questions or more information, feel free to contact us Matthew Chase, NACo Executive Director Deborah Cox: Legislative Director or 202.942.4286 Arlandis Rush: Justice and Public Safety or 202.942.4236 Paul Beddoe: Deputy Legislative Director/Health or 202.942.4234 Arthur Scott : Agriculture and Rural Affairs or 202.942.4230 Michael Belarmino: Finance & Intergovernmental Affairs or 202.942.4254 Ryan Yates: Public Lands or 202.942.4207 Daria Daniel: Community and Economic Development or 202.942.4212 Julie Ufner: Environment, Energy & Land Use or 202.942.4269 Bob Fogel: Transportation or 202.942.4217 Yejin Jang: Telecommunications and Technology or 202.942.4239 NACo was named one of nine remarkable associations in the United States after a four-year study conducted by the American Society of Association Executives and The Center for Association Leadership because of its commitment to members and purpose