8 million signed up President Obama 4/17/14

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2 Marketplace Results 8 million signed up President Obama 4/17/ million new coverage Less 5.2 million canceled policies 9.3 million newly insured Rand Corp 4/8/ million covered 8 million Marketplace 4.8 Medicaid Enroll America 5/1/14

3 414,514- Arizona Lives Covered Marketplace Enrolled(as of ): 120,071 Phoenix/Tucson 102,480 Rural areas 17,591 Medicaid (AHCCCS as of ): +294,443 (All categories) Selected AHCCCS Categories Restoration of Childless Adults 181,018 Expansion from 100% to 133% FPL 27,281 Loss of KidsCare (CHIP) (44,771)

4 Connecting to Coverage Navigators Certified Application Counselors (CAC) Health-e-Arizona Plus Assisters Insurance Brokers

5 Navigators & Application Counselors Unbiased FACILITATORS Can assist with AHCCCS or Marketplace Strict conflict of interest and privacy requirements Must show all Marketplace options Will assist in multiple languages

6 Insurance Brokers Represent multiple insurance companies; not necessarily all Marketplace plans Sell group and individual, off and on the Marketplace Paid commission by insurance company Motivated to retain customers Not trained to assist with AHCCCS

7 : Navigators Entities Arizona Alliance for Community Health Centers, Statewide Arizona Board of Regents, University of Arizona The Center for Rural Health, Tucson Campesinos Sin Fronteras, Inc., Yuma County Greater Phoenix Urban League, Inc., Maricopa, Pinal and Pima Counties

8 About the Arizona Alliance for Community Health Centers (AACHC) Arizona s Primary Care Association since Comprises the state s largest network of Primary Care Providers. Is committed to working with a variety of partners to expand tools that health centers and organizations serving those in need can utilize to address the needs of their patient populations and improve health outcomes while continuing to demonstrate a cost savings. Has strong local, state, regional and federal partners with which it leverages resources to accomplish goals. Provides a variety of educational opportunities for members, including peer networking committees which provide a forum for sharing of best practices among member colleagues for optimal healthcare delivery.

9 State-wide Reach Arizona s largest primary care network; serving rural, urban and tribal areas

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12 Everyone is entitled to his own opinion, but not to his own facts. Daniel Patrick Moynihan

13 What Is Insurance? A small known loss to protect you from a large unknown loss

14 Do It Yourself AHCCCS healthearizonaplus.gov HEAplus ( ) DES Offices Paper Applications Marketplace Healthcare.gov Marketplace hotline: (800) or TTY: (855) Paper Applications

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16 Where to Find Help Navigators and Application Counselors call 211 AHCCCS & Marketplace Online Map and Information Coveraz.org

17 New Words Too Many Words

18 Awareness Community Enrollment Evaluation Arizona s Consumer Outreach Assistance Model Coordination, continuity, accurate resources

19 How to view health plans and prices:

20 If Arizona Had 100 People Employer sponsored Insurance: 46 Medicaid (AHCCCS): 18 Medicare: 13 Private Insurance: 4 Uninsured: 18 Other Public

21 Who Has the Most to Gain? Uninsured: 18 1,000,000 Under the age of 65 AHCCCS 45% Apprx. 450,000 Marketplace 55% Apprx. 550,000

22 Opportunities to help Consumers don t understand insurance Provider networks Rx benefits Out of pocket expenses Health coverage more complex than a ticket Benefits of coverage Benefits of a healthcare home Consumer insurance literacy Lessons

23 What Consumers Should Think About Your Needs Your Budget Your Preferences

24 Helping Consumer Understand What The Options Are: Six Insurance Companies and 78 plans Favorite Company? What s Important? Travel Out of State Often? Narrowing the Options based on what the consumer wants.

25 et-official-resources.html

26 Beware Provider networks Where are the doctors and hospitals located? RX Formularies all are not the same. All sales are final can t change plans.

27 BEWARE Legitimate Brokers, Navigators and Certified Application Counselors don t charge fees to consumers for their services. www. Helathcare.com

28 Any Questions? Thank You Lourdes Paez Workforce Development Coordinator

29 Individuals Within Mixed-Status Families Eligible Under the Affordable Care Act

30 New Options for Immigrants Under the Affordable Care Act of 2010 (ACA) individuals who are lawfully present in the United States are now eligible for new affordable coverage options that started January 1, US citizens Lawfully Present

31 Immigrant Statuses that Qualify for Marketplace Coverage Lawful Permanent Resident (LPR/Green Card holder) Asylee Refugee Cuban/Haitian Entrant Paroled into the U.S. Conditional Entrant Battered Spouse, Child and Parent Trafficking Survivor and his/her Spouse, Child, Sibling or Parent Granted Withholding of Deportation or Withholding of Removal, under the immigration laws or under the Convention Against Torture (CAT) Temporary Protected Status (TPS) Lawful Temporary Resident

32 Cont. Individual with Nonimmigrant Status (includes worker visas, student visas, and citizens of Micronesia, the Marshall Islands, and Palau) Administrative order staying removal issued by the Department of Homeland Security Member of a federally-recognized Indian tribe or American Indian born in Canada Deferred Enforced Departure (DED) Deferred Action Status* *EXCEPTION: Individuals granted deferred action under the Deferred Action for Childhood Arrivals (DACA) program are not eligible to enroll in coverage in the Marketplace.

33 Mixed-Status Families What is a mixed-status family? Mixed-status family refers to a household made up of individuals with different citizenship or immigration statuses, such as a family with an undocumented mom, a lawfully present dad, a child who is a US citizen because he or she was born in the United States.

34 Quick Guide to Immigrant Eligibility for ACA

35 Who is eligible for coverage in a mixed-status family? Each member of a mixed-status family may be eligible for a different health insurance program and some members may not be eligible for any health insurance program. Eligibility for private health insurance and the subsidies that make insurance more affordable also know as premium tax credits and cost sharing reductions through the ACA s health insurance marketplace are only available to US citizens and people who are lawfully present in the US.

36 Undocumented Immigrants No federal coverage Not allowed to purchase private health insurance at full cost in a state insurance exchange Not eligible for premium tax credits or lower copayments Exempt from the individual mandate Citizen or lawfully present children of undocumented parents are eligible: To purchase from state insurance exchange For premium tax credits and lower copayments Medicaid or Children's Health Insurance Program (CHIP)

37 Undocumented Immigrants cont. Undocumented Immigrants who do not meet the Medicaid immigration eligibility requirement or are not eligible to purchase through the marketplace can still apply for : Emergency Medicaid Immunizations Community Health Centers/FQHCs Migrant Centers Others

38 Can an eligible member of a mixed family apply for Medicaid or a marketplace plan? YES! A person who is not eligible, such as an undocumented parent, may apply on behalf of eligible family members, including when the ineligible person is the head of household and the household s primary tax return filer. Immigrants in general, and mixed status families in particular, often do no know what they may be eligible for and are worried about applying. They need reassurance from eligibility workers and other experts from whom they seek help.

39 Non applicant A non applicant is someone who is not applying for health insurance but who is in an applicants household. By law, the information required from a non applicant is limited because only information strictly necessary to determine an applicants eligibility may be required. Should not be asked for their citizenship or immigration status May say I m not applying for myself. I m only applying for my child. Must provide information about their income Will be asked for SSN, but do not have to provide one if they do not have one.

40 Key Points to remember about mixed-status families An ineligible family member such as an undocumented parent may complete an application for an eligible member such as a US citizen child. By law, individuals who are not applying for themselves are not required to provide information about their citizenship or immigration status and are not required to provide a Social Security number if one is not issued to them. Information about applicants or members of their households obtained in order to determine eligibility will not be used by US Immigration and Customs Enforcement (ICE) for immigration purposes. ICE issued a clarification of this policy on 10/25/13

41 Do mixed-status families have to file tax returns because of the ACA? If a member of a mixed-status household is eligible for a premium tax credit to make health insurance more affordable under the ACA and enrolls in a health insurance, the household must file tax returns for the year in which they eligible person has health insurance. A tax return must be filed in order to reconcile the amount of the tax credit and so the applicant can be eligible for a premium tax credit when he or she renews his or her coverage for the following year. If the household s primary tax filer is not eligible for a SSN, the household must file tax returns using an ITIN.

42 Example: Mom, who is undocumented, applies for health insurance for her US citizen son. The marketplace determines that they boy is eligible for a premium tax credit and he is enrolled in health insurance for Since they boy is eligible for a premium tax credit, mom must use an ITIN to file an income tax return for the 2014 tax year by April 15, 2015, tax filing deadline

43 Individual Mandate - Penalty % of your yearly household income $95 per person for the year ($47.50 per child under 18) % of your yearly household income $325 per person % of your yearly household income $695 per person

44 Public Charge Public Charge is a term used in immigration law that describes a person who cannot support themselves and who depends on benefits that provide cash for their income. Depending on your immigration status, the Department of Homeland Security can refuse to let you enter the US, reenter the US, or become a lawful permanent resident if they think you will not be able to support yourself without these benefits in the future.

45 Highlights of Public Charge Use of Medicaid, CHIP, or other health programs by you or your family members will NOT affect the public charge decision. Use of food stamps, WIC, public housing or other noncash programs by you or your family will NOT affect the public charge decision Buying health insurance through the new health insurance marketplace and obtaining premium tax credits or cost sharing reductions that make coverage more affordable will not be considered in the public charge decision.

46 Important dates and Resources Open Enrollment for 2015 November 15, 2014 February 15, 2015 Arizona Alliance for Community Health Centers National Immigration Law Center Health Insurance Marketplace - AZ Medicaid, Nutrition Assistance + more - Cover Arizona

47 Questions?

48 Thank You! Brenda Cardenas Navigator Coordinator