Health Reform 101
Bringing the Affordable Care Act to Utah

Park City Community Forum
December 2, 2013
Summit County’s marketplace
Medical
Altius Health Plans
Arches
BridgeSpan
Select Health

60 plans

0 plans
15 plans
23 pla...
Costs for health plans will differ by metal tier
<60%

Catastrophic

60%

Bronze

Lower Premiums
Higher cost-sharing

70%
...
And now we know the 2014 premiums…
Cheapest monthly premiums by age and plan level
Rates apply to:
• Single person
• Summi...
And now we know the 2014 premiums…
Most expensive monthly premiums by age and plan level
Rates apply to:
• Single person
•...
Who will be helped?
(in billions)

16,250
Carbon, Daggett, D
uchesne, Emery, Gr
and, Morgan, San
Juan, Summit, Uint
ah, Wa...
Who is eligible for premium subsidies?

A family of four can earn up to $94,200
a year and receive a premium subsidy
Sourc...
The Reyes Family
Income: $53,000
Residence: Park City, Utah
Ages:
Dad : 45
Mom: 42
Kids: 10, 13

Annual income:
$53,000
% ...
The Shumways
Income: $44,000
Residence: Provo, Utah
Ages:
Dad : 24
Mom: 23
Kid: On the way

Annual income:
% of Poverty Le...
Mr. and Mrs. Smith
Income: $42,000
Residence: Roy, Utah
Ages: 60, 62

Annual income:
% of Poverty Level:
Expected contribu...
Find out how much you would pay…
Kaiser Family Foundation - Premium Subsidy Calculator

www.kff.org
How the ACA is funded: Cuts (in billions)
Total: $741 billion

Uncompensated care
for hospitals (DSH)

[2013-2022]

Other
...
How the ACA is funded: Taxes (in billions)
Total: $893 billion

Medical devices tax

$87

Penalties (individuals)

$55
Hig...
What are the penalties
for remaining uninsured in 2014?

$285
[Chart] Kaiser Family Foundation

$975

$2,085
Navigators and Enrollment
Who are the helpers?
Navigator

Certified Application
Counselor

Experts trained to help others evaluate their
insurance o...
Where can I get help?
www.healthcare.gov
CuidadoDeSalud.gov
Where can I get help?
www.takecareutah.org

Our trained counselors are ready to help you
understand your new options to fi...
More resources are on the way…
Where can I get help?
Dial 2-1-1

United Way’s 2-1-1 information specialists are
standing by to answer your health care qu...
Where can I get help?
Community Health Clinics
www.auch.org
Association of Utah
Community Health

Our health clinics can h...
Where can I get help?
Insurance brokers
www.utah.gov/agentsearch/search.html

www.utah.gov
Many brokers are trained and ce...
What state agencies can do…
(2) Being sick
No one can be denied
doesn’t matter
or priced out of
anymore
coverage for a pre...
Want to learn more?

Call or email UHPP to schedule a
presentation just like this one
Jason Stevenson
Education and Commun...
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Powerpoint from Jason Stevenson at Community Forum

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Jason Stevenson, Education & Stevenson Director for Utah Health Policy Project shows what health insurance options are available in Summit County.

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Powerpoint from Jason Stevenson at Community Forum

  1. 1. Health Reform 101 Bringing the Affordable Care Act to Utah Park City Community Forum December 2, 2013
  2. 2. Summit County’s marketplace Medical Altius Health Plans Arches BridgeSpan Select Health 60 plans 0 plans 15 plans 23 plans 18 plans 4 plans Source: https://https://insurance.utah.gov/health/Health%20Refrom/ACA_Rate_Individual_20131007_OnExchange.pdf Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013)
  3. 3. Costs for health plans will differ by metal tier <60% Catastrophic 60% Bronze Lower Premiums Higher cost-sharing 70% Silver 80% Gold 90% Platinum Higher Premiums Lower cost-sharing
  4. 4. And now we know the 2014 premiums… Cheapest monthly premiums by age and plan level Rates apply to: • Single person • Summit County resident • Non-smoker Age in years Source: https://https://insurance.utah.gov/health/Health%20Refrom/ACA_Rate_Individual_20131007_OnExchange.pdf Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013) Summit County
  5. 5. And now we know the 2014 premiums… Most expensive monthly premiums by age and plan level Rates apply to: • Single person • Summit County resident • Non-smoker Age in years Source: https://https://insurance.utah.gov/health/Health%20Refrom/ACA_Rate_Individual_20131007_OnExchange.pdf Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013) Summit County
  6. 6. Who will be helped? (in billions) 16,250 Carbon, Daggett, D uchesne, Emery, Gr and, Morgan, San Juan, Summit, Uint ah, Wasatch 270,000 Utahns will be eligible for premium subsidies [1] “Help is at Hand: Health Insurance Tax Credits for Utah,” Families USA, based on analysis by the Lewin Group, April 2013
  7. 7. Who is eligible for premium subsidies? A family of four can earn up to $94,200 a year and receive a premium subsidy Source: 2013 Federal Poverty Guidelines, Published in the Federal Register, January 24, 2013 http://healthpartnersamerica.com
  8. 8. The Reyes Family Income: $53,000 Residence: Park City, Utah Ages: Dad : 45 Mom: 42 Kids: 10, 13 Annual income: $53,000 % of Poverty Level: 225% Expected family contribution: 7.18% of income $9,084 $3,804 $5,280 Monthly premium: The Reyes pay: Subsidy pays: Benchmark Silver Plan Yearly premium cost: The Reyes’ contribution: Subsidy received: $757 $317 per month $440 per month Source: Kaiser Family Foundation Subsidy Calculator; http://kff.org/interactive/subsidy-calculator; Image source: CBPP
  9. 9. The Shumways Income: $44,000 Residence: Provo, Utah Ages: Dad : 24 Mom: 23 Kid: On the way Annual income: % of Poverty Level: Expected contribution: Benchmark Silver Plan $44,000 225% 7.19% of income Yearly premium cost: $6,458 The Shumway’s contribution: $3,162 Subsidy received: $3,297 Monthly premium: The Shumway’s pay: Subsidy pays: $538 $263 per month $274 per month Source: Kaiser Family Foundation Subsidy Calculator; http://kff.org/interactive/subsidy-calculator; Image source: JohnCropper
  10. 10. Mr. and Mrs. Smith Income: $42,000 Residence: Roy, Utah Ages: 60, 62 Annual income: % of Poverty Level: Expected contribution Yearly premium cost: The Smith’s contribution: Subsidy received: $10,698 $3,634 $7,064 Monthly premium: The Smiths pay: Subsidy pays: Benchmark Silver Plan $42,000 271% 8.65% of income $891 $303 per month $589 per month Source: Kaiser Family Foundation Subsidy Calculator; http://kff.org/interactive/subsidy-calculator; Image source: Creative Commons
  11. 11. Find out how much you would pay… Kaiser Family Foundation - Premium Subsidy Calculator www.kff.org
  12. 12. How the ACA is funded: Cuts (in billions) Total: $741 billion Uncompensated care for hospitals (DSH) [2013-2022] Other $114 $56 $156 Medicare / Medicaid payment rates $415 Medicare Advantage [Chart] CBO / Washington Post Wonkblog http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/30/how-congress-paid-for-obamacare-in-two-charts//
  13. 13. How the ACA is funded: Taxes (in billions) Total: $893 billion Medical devices tax $87 Penalties (individuals) $55 High-earners capital gains taxes [2013-2022] Penalties (employers) $106 ‘Cadillac’ $111 health plans $318 $216 Cost-savings [Chart] CBO / Washington Post Wonkblog http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/30/how-congress-paid-for-obamacare-in-two-charts//
  14. 14. What are the penalties for remaining uninsured in 2014? $285 [Chart] Kaiser Family Foundation $975 $2,085
  15. 15. Navigators and Enrollment
  16. 16. Who are the helpers? Navigator Certified Application Counselor Experts trained to help others evaluate their insurance options on the new insurance marketplace.
  17. 17. Where can I get help? www.healthcare.gov CuidadoDeSalud.gov
  18. 18. Where can I get help? www.takecareutah.org Our trained counselors are ready to help you understand your new options to find affordable health care coverage today
  19. 19. More resources are on the way…
  20. 20. Where can I get help? Dial 2-1-1 United Way’s 2-1-1 information specialists are standing by to answer your health care questions
  21. 21. Where can I get help? Community Health Clinics www.auch.org Association of Utah Community Health Our health clinics can help you enroll in new insurance coverage for you and your family.
  22. 22. Where can I get help? Insurance brokers www.utah.gov/agentsearch/search.html www.utah.gov Many brokers are trained and certified to help individuals and businesses with enrollment
  23. 23. What state agencies can do… (2) Being sick No one can be denied doesn’t matter or priced out of anymore coverage for a preexisting condition (1) healthcare.gov 70% (4) Subsidies will make premiums more affordable (5) Navigators will help you sign up 60% (in bill ion s) 80% (3) It’s private insurance (and it’s good insurance) 90%
  24. 24. Want to learn more? Call or email UHPP to schedule a presentation just like this one Jason Stevenson Education and Communications Director cell. 617-290-8188 work. 801-433-2299 ext. 7 stevenson@healthpolicyproject.org

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