2014 reform-movieforml

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  • Oregon is expanding Medicaid, also known as the Oregon Health Plan, to an estimated 16,000 new adults in Jackson County. Thousands of others already enrolled in the OHP Standard plan will gain more comprehensive benefits. Others will have access to tax credits that help them pay health insurance premiums through a new program called an “insurance marketplace.” These changes take effect Jan. 1, but they are not automatic. People who want to take advantage of these new options will have to take some action.
  • Who are these 16,000 Jackson County residents who will be newly eligible for the Oregon Health Plan?
  • This chart shows current Federal Poverty Level income guidelines. Under the OHP expansion, a family of four making less than about $32,500 a year will qualify for OHP. If you’re by yourself, the annual income limit is about $16,000. The shaded areas show income ranges that will qualify for OHP.
  • Another group will do well in this transition. It’s made up of people who are now enrolled in the OHP Standard plan. As of Jan. 1, they will automatically move to the OHP Plus plan, and under that new plan they will gain more comprehensive health benefits.
  • We’ll go back to this Federal Poverty Level chart. The OHP expansion is providing for people earning incomes at the lower end of the chart, and a new program called the “insurance marketplace” was created to help people with incomes between 139 percent and 400 percent of the poverty level. Under this program a family of four earning as much as $94,200 annually or a single person earning as much as $45,960 annually will qualify for subsidies designed to help them pay insurance premiums. These subsidies will come in the form of tax credits and, for some lower-income earners, lower deductibles and co-payments.
  • We’ll go back to this Federal Poverty Level chart. The OHP expansion is providing for people earning incomes at the lower end of the chart (click), and a new program called the “insurance marketplace” was created to help people with incomes between 139 percent and 400 percent of the poverty level (click). Under this program a family of four earning as much as $94,200 annually or a single person earning as much as $45,960 annually will qualify for subsidies designed to help them pay insurance premiums. These subsidies will come in the form of tax credits and, for some lower-income earners, lower deductibles and co-payments.
  • All states have some form of this insurance marketplace, and Oregon has named its program “Cover Oregon.” The state has created this website, which includes all sorts of information about the changes, at www.coveroregon.com. The site includes an online calculator (click) where you can enter your household income and find out whether you’re eligible for either the OHP expansion or tax credits on premiums. Cover Oregon and sites like it in other states are designed to provide “easy” comparison shopping for consumers. Insurance plans will be rated on the coverage and services they provide to help consumers understand what they’re buying.One of the biggest misconceptions about these marketplaces, which are also sometimes called “exchanges,” is that they're only for people who don't have insurance. People who work part time and don't qualify for benefits; people who are self-employed; or people who may have retired early and don't yet qualify for Medicare can apply for insurance through this system.
  • When you click on the calculator button on the Cover Oregon homepage, you go to another page where you can choose whether you’re calculating costs for an individual or family or small employer, and if we click on individual/family,
  • We go to this page, where you enter your household income, age, number of adults and children in your household, and then hit “calculate.” The site will tell you at that point whether you qualify for a discount on insurance premiums or OHP or neither. You can do this much on the site now. Beginning in October, you’ll be able to proceed further and compare insurance plans or sign up for Oregon Health Plan.
  • Again, you’ll enter your income, age, and household size, and the site will let you know whether you qualify for OHP or, at higher incomes, a subsidy. Bottom line: If you’re an individual making up to $45,960 or in a family of four making up to $94,200 for the household, you should be eligible for at least a bit of a subsidy.
  • Insurance will continue to be expensive, especially for people whose income is only slightly too high for them to qualify for OHP. Health care reform’s aim, however, is that as many people as possible are insured. So starting in 2014, uninsured people will face penalties for being uninsured.
  • After 2016, penalties will increase with inflation.In the first year, the penalty is $95 per adult and $47.50 per child (up to $285 for a family) or 1.0% of household income, whichever is greater.For example, the penalty for an individual earning $30,000 a year would be $300 in 2014, $600 in 2015 and $750 in 2016.  This penalty will be assessed on your tax return.
  • The Family Health Insurance Assistance Program will end Dec. 31, and most people will have other options through Cover Oregon. Those who are currently members of FHIAP will receive information through letters, newsletters, and the website at: www.fhiap.oregon.gov.
  • You might be wondering why we’re here today providing this information. Community Health Center and La Clinica both are federally qualified health centers and both receive government funding. We exist to ensure people have access to health care, and the government has determined health centers like ours have a role in making sure people understand their options. Both of us are training staff this summer to understand these changes and to be able to help people through what can be a confusing process.
  • 2014 reform-movieforml

    1. 1. Health care reform and you: What to expect in 2014
    2. 2. Health care is changing in 2014. People across the U.S. will have new options for health care as the final pieces of the Affordable Care Act become law.
    3. 3. •16,000 new Jackson County adult Medicaid (OHP) patients • More comprehensive benefits for current OHP Standard plan enrollees •About 22,000 Jackson County residents eligible for tax credits that help pay for insurance premiums
    4. 4. New to OHP • Adults (19-64) • Legal residents of U.S. (this can be complex) • Household income at or less than 138 percent of the Federal Poverty Level
    5. 5. OHP Standard enrollees will be converted to OHP Plus and will gain new benefits, including: •Comprehensive dental care •Some vision care •Hearing aids •Physical therapy •Labor and delivery care
    6. 6. What if you make too much money to be eligible for OHP?
    7. 7. The OHP expansion is providing for people earning incomes at the lower end of the Federal Poverty Level, and a new program called the Cover Oregon was created to help people with incomes between 139 percent and 400 percent of the poverty level. Under this program a family of four earning as much as $94,200 annually or a single person earning as much as $45,960 annually will qualify for subsidies designed to help them pay insurance premiums. These subsidies will come in the form of tax credits and, for some lower-income earners, lower deductibles and co- payments.
    8. 8. Shopping on coveroregon.com • Level of subsidy is income-based • People with insurance through an employer are not eligible to buy here (some exceptions) • People already insured individually can buy insurance here
    9. 9. • New benefits go into effect Jan. 1 • People can enroll starting Oct. 1 • Apply online or by filling out an application • La Clinica has employees who understand these changes and can help people figure out eligibility
    10. 10. What if I earn too much to qualify for OHP but don’t have the money to buy insurance?
    11. 11. Adults in uninsured households will pay increasing penalties over each of the next three years: $95 (or 1%) in 2014 $395 (or 2%) in 2015 $695 (or 2.5%) in 2016 2014 2015 2016
    12. 12. However, if insurance costs 8 percent or more of your income, it is considered unaffordable and you don’t have to pay a penalty. 2014 2015 2016
    13. 13. What about kids? Many Oregon children have OHP coverage through a program called Oregon Healthy Kids, and that coverage is not ending with this change. When enrollment becomes available in October, Healthy Kids will be one type of coverage available.
    14. 14. What about seniors? People who are eligible for Medicare are not affected by most of these changes, although the Affordable Care Act does provide for slight benefit improvements for Medicare recipients.
    15. 15. What about FHIAP? The Family Health Insurance Assistance Program will end Dec. 31, and most people will have other options through Cover Oregon. Those who are currently members of FHIAP will receive information through letters, newsletters, and the website at: www.fhiap.oregon.gov.
    16. 16. When to apply • OHP enrollment is year round, but enrollment for these new benefits begins Oct. 1. • Other Cover Oregon enrollment starts Oct. 1 and ends March 31, 2014, then starts again Oct. 1, 2014.
    17. 17. How to apply • La Clinica can help with information now or with enrollment as of Oct. 1. We have employees available at every site to help. • As of Oct. 1, you can enroll online yourself at www.coveroregon.com.
    18. 18. For more information • Cover Oregon: www.coveroregon.com • La Clinica: www.laclinicahealth.org/2014 or 541-535-6239
    19. 19. Thank you! Questions?

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