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Planning in a time of uncertainty and change …

Planning in a time of uncertainty and change

This presentation was originally conducted at the Office of HIV Planning's Community Empowerment Workshop held at St. Luke's Church on October 16, 2012.

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  • the product of applying research done by the Kaiser Commission on Medicaid and the Uninsured to our EMA. These are estimates based on EMA data that has been noted as limited, due to duplications. OHP staff calculated the projections based on the data reported by AACO for insurance status for 2010, using the participation percentages in the Kaiser report. These participation estimates assumed that those with employer sponsored coverage would have similar participation regardless of outreach efforts (25%). However, the uninsured participation is expected to increase from 57% in the standard participation to 75% in the enhanced participation scenario. Individuals covered under other insurance types were not considered for this model. These projections result in 63% - 66% of Ryan White clients being Medicaid enrolled (this includes the individuals already enrolled in Medicaid). Between 4% - 7% of Ryan White clients will remain uninsured. However, those captured within that 4-7% uninsured may gain access to insurance through employers or through the state insurance exchanges. This Medicaid range is less than the estimate above that 75% of Ryan White clients will be Medicaid-eligible based on income alone, because the Kaiser projections are for enrollment, not just eligibility. There will be a number of individuals who do not enroll in Medicaid for any number of reasons, including lack of knowledge of eligibility, lack of the proper documentation of eligibility, and not wanting to participate.
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  • 1. HIV Policy 2012Planning in a time of uncertainty and change
  • 2. Let’s remember how far we have comehttp://youtu.be/haEPLCA_H2Y
  • 3. HIV in the 21st Century National HIV/AIDS Strategy Ryan White Program Health Reform ‘Medical Model’ Clinical Care Team ‘Treatment as Prevention’ Test and Treat Strategy High Impact HIV Prevention Prevention with Positives Enhanced Comprehensive HIV Prevention Planning
  • 4. HIV Programs in US Ryan White Program Medicaid Medicare Housing Opportunities for People With AIDS - HOPWA Centers for Disease Control and Prevention- CDC AIDS Drugs Assistance Program - ADAP Substance Abuse and Mental Health Services Administration - SAMHSA Veterans Administration - VA
  • 5. Ryan White MedicaidReauthorization Expansion 2014 2013 Uncertainty Elections Essential HealthNovember 2012 Benefits
  • 6. http://youtu.be/vmdbllWOOzs
  • 7. Affordable Care ActExpansion of MedicaidNo discrimination by insurance companies No $ limits Subsidies for Essential Coordination premiums andhealth benefits of care cost-sharing
  • 8. Ryan White and Medicaid Expansion 51% Medicaid (disability) ~90%+ Ryan White clients Medicaid eligible in Medicaid 2014 Expansion to cover 133% FPL
  • 9. Ryan White Clients Insurance Ryan White Clients Status, 2009 Income, 2009 Unknown 1% <100% FPL 100-199% 200-299% >300%Other None Private 4% 5%Public 17% 17% 1% 13% Medicare 13% Medicaid 78% 51%
  • 10. Estimated Changes to Insurance Status for Philadelphia EMA Ryan White Clients Following the Full Implementation of the ACA9000 83158000 79427000 625060005000 Medicaid4000 ESI Uninsured3000 2,047 1,5352000 2,071 1,5351000 891 518 0 Baseline RW 2014 Average 2014 Enhanced Participation Participation
  • 11. Health Reform and Ryan White Medicaid 75/25 rule?? Expansion??
  • 12. Health Reform and Ryan White Programhttp://vimeo.com/46052691
  • 13. National HIV AIDS Strategy Reduce HIV rate Coordinate d response Increase access to care for people Reduce HIV- living with HIV and related health improve their inequalities health outcomes
  • 14. Ryan White MedicaidReauthorization Expansion 2014 2013 Uncertainty Elections Essential HealthNovember 2012 Benefits
  • 15. resources HIVHealthReform.org Kaiser Family Foundation  www.kff.org Commonwealth Fund  www.commonwealthfund.org/ Office of HIV Planning  www.hivphilly.org Nicole Johns Office of HIV Planning 215-574-6760 ext. 108 Nicole.johns@gmail.com