Health care reform and you:What to expect in 2014

Health care is changing in 2014. People across the U.S. will have new options for health care as the final pieces of the Affordable Care Act become law.

•16,000 new Jackson County adult Medicaid (OHP) patients

• More comprehensive benefits for current OHP Standard plan enrollees

•About 22,000 Jackson County residents eligible for tax credits that help pay for insurance premiums

New to OHP• Adults (19-64)• Legal residents of U.S.

(this can be complex)• Household income at or less

than 138 percent of the Federal Poverty Level

OHP Standard enrollees will be converted to OHP Plus and will gain new benefits, including:

•Comprehensive dental care•Some vision care•Hearing aids•Physical therapy•Labor and delivery care

What if you make too much money

to be eligible for OHP?

The OHP expansion is providing for people earning incomes at the lower end of the Federal Poverty Level, and a new program called the Cover Oregon was created to help people with incomes between 139 percent and 400 percent of the poverty level.

Under this program a family of four earning as much as $94,200 annually or a single person earning as much as $45,960 annually will qualify for subsidies designed to help them pay insurance premiums. These subsidies will come in the form of tax credits and, for some lower-income earners, lower deductibles and co-payments.

Shopping on coveroregon.com• Level of subsidy is income-based• People with insurance through an

employer are not eligible to buy here (some exceptions)

• People already insured individually can buy insurance here

• New benefits go into effect Jan. 1• People can enroll starting Oct. 1• Apply online or by filling out an

application• La Clinica has employees who

understand these changes and can help people figure out eligibility

What if I earn toomuch to qualifyfor OHP butdon’t have the money to buyinsurance?

Adults in uninsured households will pay increasing penalties over each of the next three years:

$95 (or 1%) in 2014$395 (or 2%) in 2015$695 (or 2.5%) in 2016

2014

2015

2016

However, if insurance costs 8 percent or more of your income, it is considered unaffordable and you don’t have to pay a penalty.

2014

2015

2016

What about kids?Many Oregon children have OHP coverage through a

program called Oregon Healthy Kids, and that coverage is not ending with this change. When enrollment becomes available in October, Healthy Kids will be one type of coverage available.

What about seniors?People who are eligible for Medicare are not affected by

most of these changes, although the Affordable Care Act does provide for slight benefit improvements for Medicare recipients.

What about FHIAP? The Family Health Insurance Assistance Program will end Dec. 31,

and most people will have other options through Cover Oregon. Those who are currently members of FHIAP will receive information through letters, newsletters, and the website at: www.fhiap.oregon.gov.

When to apply• OHP enrollment is year round, but

enrollment for these new benefits begins Oct. 1.

• Other Cover Oregon enrollment starts Oct. 1 and ends March 31, 2014, then starts again Oct. 1, 2014.

How to apply• La Clinica can help with

information now or with enrollment as of Oct. 1. We have employees available at every site to help.

• As of Oct. 1, you can enroll online yourself at www.coveroregon.com.

For more information

• Cover Oregon: www.coveroregon.com

• La Clinica: www.laclinicahealth.org/2014 or 541-535-6239

Thank you!Questions?