Health Reform 101 Bringing the Affordable Care Act to Utah
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1 Health Reform 101 Bringing the Affordable Care Act to Utah Utah s Final Enrollment Report October 1, 2013 April 19, 2014 Utah Health Policy Project Sustainable healthcare solutions for underserved Utahns
2 84,601 Utahns signed up for coverage on healthcare.gov October 1, 2013 April 19, 2014 by October 31 by November 30 by December 28 by February 1 84,601 by March 1 by April 19 39,902 Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014
3 Utah s pace of enrollment surged in March 2014 October 1, 2013 April 19, 2014 by October 31 by November 30 by December 28 by February 1 by March 1 by April 19 16,768 10,786 10,483 44,699 Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014
4 March-April were the busiest months for Utah enrollment October 1, 2013 April 19, 2014 ACA Sign-ups in Utah per Day (by month) Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014
5 Utah s ACA enrollment out-paced similar states October 1, 2013 April 19, 2014 % of enrollment goal met - by state population Marketplace Status State Federal State population (in mil) % of overall enrollment goal Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014
6 Utah beat its monthly enrollment goal for March 2014 October 1, 2013 April 19, 2014 Utah achieved 392% of its March enrollment goal Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014
7 Utah topped its overall enrollment goal in March 2014 October 1, 2013 April 19, ,990 9,690 Enrolled 26,790 Target 35,340 45,600 57,000 Utah reached 148% of its total enrollment target by April 19 Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014
8 87% of Utahns qualified for premium subsidies October 1, 2013 April 19, 2014 Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014
9 Utah led the nation in enrolling year olds October 1, 2013 April 19, 2014 Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014
10 Who can buy insurance after March 31 st?
11 The Affordable Care Act (ACA) Also called Obamacare Initial enrollment period: October 1, 2013 March 31, 2014 Special enrollment period (SEP) lasts from April 1, 2014 to November 14, 2014 Next Enrollment Period (for 2015): November February 15, 2015
12 Can you buy health insurance today? Yes if you have a qualifying life event that triggers a Special Enrollment Period (SEP) No if you don t qualify for a special enrollment period* (*) Some Utah insurers will sell short-term insurance plans that are not ACA compliant
13 What happens after March 31 st? If you Experience a Qualifying Life Event Don t experience a Qualifying Life Event You can Get a 60-day window to enroll in new insurance for yourself and yourr family Sign up for insurance on healthcare.gov Be eligible for subsidies Apply for Medicaid (if eligible) Purchase non-aca coverage direct from an insurer Wait for November 15, 2014 Pay tax fine (if required)
14 What is a Qualifying Life Event? It triggers a 60-day Special Enrollment Period Getting married or divorced Having a baby Adopting a child or placing a child for adoption or foster care Moving outside your insurer s coverage area Losing other insurance due to loss of job, divorce, the end of an individual policy, COBRA expiration, aging off a parent s plan (at age 26), losing eligibility for Medicaid or CHIP, and similar circumstances. Gaining citizenship Leaving incarceration Source: healthcare.gov ;
15 What is a Qualifying Life Event? Getting sick Forgetting to sign up for insurance before March 31, 2014 Voluntarily ending insurance coverage Losing coverage that doesn t qualify as minimum essential coverage under the ACA
16 What is a Complicated Case? You can still enroll if you couldn t sign up for coverage before March 31 st because of. A serious medical condition or natural disaster An unexpected hospitalization or temporary cognitive disability Medicaid/Marketplace transfer delays Misinformation or misrepresentation by brokers or assistors System errors related to immigration status Victims of domestic abuse A Marketplace system outage, such as Social Security Administration system outage
17 How do I sign up? Go to healthcare.gov Register your qualifying life event and pick a plan See if you qualify for a premium subsidy Prepare documentation if you have a complicated case >> Learn more about exemptions from the fine/penalty: >> Download the hardship waiver form: publications-and-articles/hardship-exemption.pdf
18 What are your coverage options? If you can t buy insurance before November 15, 2014 Seek reduced-cost care at one of Utah s Community Health Clinics (CHCs) Patients pay a sliding-scale fee based on income Phone: (801) Apply for Utah s Primary Care Network (PCN) PCN (Primary Care Network) is a state-run Medicaid program for people who don t qualify for traditional Medicaid. We expect about 3,000 new slots to open up in May Check the PCN website:
19 Where can Utahns find help?
20 Where can Utahns find help? Dial 2-1-1
21 Where can Utahns find help? Community Health Clinics Association of Utah Community Health
22 Where can I get help? Insurance brokers Many brokers are trained and certified to help individuals and businesses with enrollment
23 For more information: Jason Stevenson Education and Communications Director cell work ext. 7 stevenson@healthpolicyproject.org
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