THCC MTMHI Training

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This is one of many presentations I put together for our public education efforts at THCC. I tailored every presentation to the needs or requests of the group. This was specifically for a community mental health facility given mostly to direct service social workers as part of their continuing education credit hours.

Healthcare

Tennessee Health Care
Health Reform
GuaranteedCoverage
3

Tennessee Health Care
Unpacking the
Affordable Care Act
Essential Health
Benefits
Donut Hole
Primary Care
Young Adults
Pre-Existing
Conditions
Eliminated
Medicaid Expansion
Premium Subsidies
Lifetime & Annual
Caps Eliminated
80/20 Rule
Small Business Tax Credits
6

Tennessee Health Care
Prevention & Wellness
Alcohol Misuse
Depression
Immunizations
Diet Counseling
Type 2 Diabetes
Blood Pressure
Obesity
Cholesterol
HIV
Tobacco Use
STI Prevention
Well Baby/Child Visits
7

Tennessee Health Care
Prevention & Wellness
for the ladies
STI Counseling
OB/GYN w/o referral
Gestational Diabetes
Screening
Breastfeeding
Support & Supplies
Contraception &
Contraceptive Counseling
HIV Screening & Counseling
Cervical Cancer
Screening
HPV DNA Testing
Well-Woman VisitsBreast Cancer
Mammography &
Chemoprevention
Domestic Violence
Screening & Counseling
8

Tennessee Health Care
Coming Up
Insurance MarketplaceTENNCARE EXPANSION*
9

Tennessee Health Care
FPL
400%
300%
200%
100%
Children
(CoverKids)
Undocumented
Immigrants
Adults w/o
Children
People with
Disabilities
ParentsPregnant
Women
0% 0%
■ Medicaid and CHIP (Tennessee 2012 eligibility levels)
■ Uninsured or insured via other coverage source
Insurance
Marketplace Subsidized
Unsubsidized
2014138% Medicaid Expansion126%
75%
Linking Tennesseans to Coverage (2014)
185%
250%
138%
10

Tennessee Health Care
Small
Businesses
Individuals &
Families
IRS
SSA
INS
Qualified Health Plans
SHOP Qualified Health Plans
SHOP Marketplace
Federal Insurance Marketplace
11

Tennessee Health Care
Easy Shopping Experience
• Easy-to-read format
• Glossary of terms
(deductible, co-pay,
etc)
• Costs & benefits in
plain English on two
sheets of paper
12

Tennessee Health Care
The
“IF”
Factor
14

Tennessee Health Care
The Politics
“For the last several months, I’ve been working
toward a ‘Tennessee Plan’ for health reform to
change the way health care coverage looks in
Tennessee. … The plan would include co-pays
for those that can afford to pay something, so
the user has some skin in the game when it
comes to health care incentives. We would work
with providers to lower the cost of care and to
move from a model of paying for every service
regardless of the result, to a payment method
that is based on outcomes and quality care. Our
plan would have a definitive circuit-breaker or
sunset that could only be renewed with the
General Assembly’s approval based on when
the amount of the federal funding decreases.”
- Gov. Bill Haslam, 3/27/2013
Gov. Scott, Florida
Gov. Sandoval, Nevada
Gov. Martinez, New Mexico
Gov. Kasich, Ohio
Gov. Christie, New Jersey
Gov. Brewer, Arizona
Gov. Tomblin, W. Virginia
Gov. Dayton, Minnesota
Gov. Snyder, Michigan
Gov. Dalrymple, N. Dakota

Tennessee Health Care
The Opportunity in Tennessee
Sources: Kaiser Commission on Medicaid and the Uninsured, Urban Institute, projections based
on Census Bureau’s 2010 and 2011 Current Population Survey
Federal
Poverty
Level
0 -
138%
100% –
138%
139% –
399% > 400% Total
Number of
Uninsured
547,476 145,819 329,922 50,319 927,717
Coverage
Option
under ACA
TennCare*
TennCare*
or
Marketplace
Marketplace
with tax
credits/su
bsidies
Marketplace
with no
credits
*If Tennessee chooses to expand Medicaid
17

Tennessee Health Care
Questions?
Comments?
Violent Dissent?

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1. Tennessee Health Care Brad A. Palmertree, BSW Tennessee Health Care Campaign The New Health Insurance Marketplace: The Impact of Health Reform in Tennessee

2. Tennessee Health Care Public Policy Advocacy Grass- roots Direct Service Tennessee Health Care Campaign Working for affordable access to high-quality health care for all Tennesseans 2

3. Tennessee Health Care Health Reform GuaranteedCoverage 3

4. Tennessee Health Care 4

5. Tennessee Health Care 5 Well…. kinda

6. Tennessee Health Care Unpacking the Affordable Care Act Essential Health Benefits Donut Hole Primary Care Young Adults Pre-Existing Conditions Eliminated Medicaid Expansion Premium Subsidies Lifetime & Annual Caps Eliminated 80/20 Rule Small Business Tax Credits 6

7. Tennessee Health Care Prevention & Wellness Alcohol Misuse Depression Immunizations Diet Counseling Type 2 Diabetes Blood Pressure Obesity Cholesterol HIV Tobacco Use STI Prevention Well Baby/Child Visits 7

8. Tennessee Health Care Prevention & Wellness for the ladies STI Counseling OB/GYN w/o referral Gestational Diabetes Screening Breastfeeding Support & Supplies Contraception & Contraceptive Counseling HIV Screening & Counseling Cervical Cancer Screening HPV DNA Testing Well-Woman VisitsBreast Cancer Mammography & Chemoprevention Domestic Violence Screening & Counseling 8

9. Tennessee Health Care Coming Up Insurance MarketplaceTENNCARE EXPANSION* 9

10. Tennessee Health Care FPL 400% 300% 200% 100% Children (CoverKids) Undocumented Immigrants Adults w/o Children People with Disabilities ParentsPregnant Women 0% 0% ■ Medicaid and CHIP (Tennessee 2012 eligibility levels) ■ Uninsured or insured via other coverage source Insurance Marketplace Subsidized Unsubsidized 2014138% Medicaid Expansion126% 75% Linking Tennesseans to Coverage (2014) 185% 250% 138% 10

11. Tennessee Health Care Small Businesses Individuals & Families IRS SSA INS Qualified Health Plans SHOP Qualified Health Plans SHOP Marketplace Federal Insurance Marketplace 11

12. Tennessee Health Care Easy Shopping Experience • Easy-to-read format • Glossary of terms (deductible, co-pay, etc) • Costs & benefits in plain English on two sheets of paper 12

13. Tennessee Health Care 13

14. Tennessee Health Care The “IF” Factor 14

15. Tennessee Health Care 15

16. Tennessee Health Care The Politics “For the last several months, I’ve been working toward a ‘Tennessee Plan’ for health reform to change the way health care coverage looks in Tennessee. … The plan would include co-pays for those that can afford to pay something, so the user has some skin in the game when it comes to health care incentives. We would work with providers to lower the cost of care and to move from a model of paying for every service regardless of the result, to a payment method that is based on outcomes and quality care. Our plan would have a definitive circuit-breaker or sunset that could only be renewed with the General Assembly’s approval based on when the amount of the federal funding decreases.” - Gov. Bill Haslam, 3/27/2013 Gov. Scott, Florida Gov. Sandoval, Nevada Gov. Martinez, New Mexico Gov. Kasich, Ohio Gov. Christie, New Jersey Gov. Brewer, Arizona Gov. Tomblin, W. Virginia Gov. Dayton, Minnesota Gov. Snyder, Michigan Gov. Dalrymple, N. Dakota

17. Tennessee Health Care The Opportunity in Tennessee Sources: Kaiser Commission on Medicaid and the Uninsured, Urban Institute, projections based on Census Bureau’s 2010 and 2011 Current Population Survey Federal Poverty Level 0 - 138% 100% – 138% 139% – 399% > 400% Total Number of Uninsured 547,476 145,819 329,922 50,319 927,717 Coverage Option under ACA TennCare* TennCare* or Marketplace Marketplace with tax credits/su bsidies Marketplace with no credits *If Tennessee chooses to expand Medicaid 17

18. Tennessee Health Care

19. Tennessee Health Care Questions? Comments? Violent Dissent?

Editor's Notes

Beth’s slide about numbers to reach

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