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Obamacare in Action

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Introduction

Health Care Reform in 2014

Connect for Health Colorado

Overview

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Our mission: barrier-free access to quality, affordable

health care for all Coloradans Nonpartisan, nonprofit consensus based membership

organization

Approximately 50 organizational members

25 Individual members

www.cohealthinitiative.org

Colorado Consumer Health

Initiative: Who We Are

http://www.cohealthinitiative.org/http://www.cohealthinitiative.org/

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Three Pillars of Health Care

Reform

Contain Costs Expand CoverageEnsure Quality

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Pilot programs for bundling payments

Improve care coordination for dual eligibles

Increased Medicaid payments for primary

care providers

Collection and reporting of data on healthdisparities

Improving Quality/Health System

Performance

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Adopt single set of operating rules for eligibility

verification and claims status Reduced Medicare payments to hospitals with

preventable readmissions, hospital acquired

infections

Reduce Medicare disproportionate share hospital

payments

Restructure payment to Medicare

Advantage plans

Cost Containment

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In 2014, everyone will be required to have healthinsurance that meets a minimum standard of quality

and coverage (certain exemptions)

Employer responsibility: Large employers (200+): automatically enroll

employees (employees can opt out) Mid-sized employers (50+): offer coverage or pay

a penalty Small employers (< 50 employees):

no mandate

Expanding Coverage

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Expanding Coverage: How many uninsured adultsand children stand to become insured after health

reform?

800,000

258,000

175,000

153,000214,000

Source: Colorado Health Institute

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Private Market Reforms

2010

Dependents up to age 26 can

stay on parents plans

No exclusion for pre-existing

conditions for children

No lifetime limits

No rescissions

Insurers must spend at least80% of premium on health care

(the 80/20 rule or MLR)

Free preventive care

2014

No annual limits on coverage

Guaranteed issue andrenewability

Essential health benefits for small

group and individual plans

Rating only on 4 factors

Age (3:1) Location

Family size

Tobacco usage (1.15:1)

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Medicaid Expansion

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Connect for Health Colorado

www.connectforhealthco.com

http://www.connectforhealthco.com/http://www.connectforhealthco.com/

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