Expanding Access to Health Care in Denver under the ACA

Expanding Access to Health Care in Denver under the ACA
Percent Uninsured
Nearly 20% of Denver’s population, an estimated 104,000 residents, lack health insurance, and an even
higher number lack dental insurance. Some of the benefits of insurance include:
• Improved access to care and the ability to have a
consistent care provider.
• Increased use of preventive services, such as cancer
screening.
50% Lack of Insurance in Denver
• Protection from some of the financial risks related to
40%
medical costs.
29%
26%
30%
23%
21%
• Improved mental health.
20%
Who lacks health insurance now?
Denver’s uninsured are predominantly younger adults
between 19 and 49 years of age. Other groups who are
more likely to be uninsured include:
• Men more than women.
• Hispanics more than Whites, Blacks and other races.
• Single people more than married, divorced or separated.
• People who live in west and north Denver more than
people in other parts of the city.
10%
0%
17%
14%
9%
14%
11%
13%
1%
Source: 2011 American Community Survey
New coverage opportunities in 2014
The Patient Protection and Affordable Care Act (ACA) is a historic opportunity to improve the health of Denver
residents. It has already expanded health coverage for young adults by allowing them to stay on their parents’
plans until age 26, and eliminated denials of health insurance coverage for children with pre-existing
conditions. In 2014 the ACA will also:
• Significantly expand eligibility for Medicaid to be strictly income-based.
• Provide governmental assistance for many people to purchase health insurance through Colorado’s new
health insurance exchange, Connect for Health Colorado.
• Eliminate denials of health insurance coverage for
all persons with pre-existing conditions.
Denver Residents Eligible for New
Coverage in 2014
How many Denver residents will qualify?
• More than 75,000 Denver residents, or 72% of
the uninsured population, are expected to qualify
for either Medicaid or subsidized insurance
through the Exchange.
• Another 7% will be required to purchase
insurance without governmental support, but
should be able to do so for less on the Exchange.
• Undocumented persons will not be eligible for
expanded coverage under Medicaid or the
Exchange.
Source: 2011 American Community Survey
Window of Opportunity for Access to Care in 2014
The ACA offers an unprecedented opportunity to increase
access to care for Denver residents and to change our
health care delivery system from a high-cost, episodic,
“sick care” system to a more comprehensive, preventive
health care system that integrates primary care,
behavioral health care, and substance abuse treatment.
The ACA contains many provisions for promoting
prevention and wellness, protecting consumers, improving
health care quality and system performance, and curbing
rising health costs.
Despite these enormous opportunities, several factors
could inhibit the expansion of coverage:
• Lack of knowledge about the ACA. A recent Kaiser
Family Foundation poll found that 42% of Americans
did not know that the ACA was law.
• Reluctance to enroll in governmental programs or to
purchase insurance through the Exchange, despite the
subsidies offered, and given the small penalty in 2015
for failing to purchase health insurance.
• Confusion resulting from the large number of
insurance plans (150) offered on the Exchange.
Free Preventive Services Under ACA
Pregnancy
Pediatrics
Sexual Health
Infections
Mental Health
Cardiovascular
Disease
Screening for anemia & infections; vitamins
Cancer
Screening for breast, cervical, & colon cancer
Tobacco
Screening & cessation services
Hearing & vision screening; vaccinations
STD screening & prevention
Hepatitis C & HIV testing; adult vaccinations
Depression screening
Screening for high blood pressure, diabetes,
high cholesterol, & obesity
Potential Benefits of ACA in CO
•
•
•
•
•
•
Lower cost to taxpayers for uncompensated care.
Mitigation of extra costs paid by the insured to cover
uncompensated care.
6-17% reduction in growth of health care costs.
10-25% reduction in premiums for employersponsored insurance.
19,000 new jobs.
1% increase in economic output due to freed up
resources, job creation, increased worker productivity.
Source: The Colorado Trust (2011), Issue Brief: The Economic Impact of
Health Reform in Colorado.
What Can You Do to Increase Access to Care in Denver?
•
•
•
Advocate with family, friends, and colleagues about the benefits of health insurance and the new
opportunities for coverage under the ACA in 2014.
Provide information about the ACA and the new types of coverage to friends, family, clients, patients, staff
and visitors to your organization.
Help people get signed up. Direct them to online sites and in-person enrollment assistance sites to check
their eligibility for Medicaid and subsidized insurance through the Exchange, and to sign up.
Medicaid
When to Apply: Starting October 1, 2013
Deadline:
None
Coverage Starts: January 1, 2014
Who is Eligible: Up to 133% FPL
$15,282/year - single
$32,322/year - family of four
Phone:
Toll-free: 1-800-221-3943
TDD: 1-800-659-2656
Apply Online:
Colorado.gov/PEAK
Apply in Person: Lists of sites available at:
colorado.gov/apps/maps/hcpf.map
Connect for Health Colorado
When to Apply:
Deadline:
Coverage Starts:
Who is Eligible:
Starting October 1, 2013
March 31, 2014
January 1, 2014
133-400% FPL for subsidy
$45,900/year – single
$94,200/year – family of four
If not covered by employer
If not eligible for Medicare
Phone:
Toll-free: 1-855-PLANS4YOU
Toll-free: 1-855-752-6749
Apply Online:
ConnectforHealthCO.com
Apply in Person: List of sites available at:
connectforhealthco.com/let-us-help/assistance-network/