ACCIPP 9-7-12

State and Federal Health Care Reform in Alameda County: Impact on Children of

Incarcerated Parents-Data on the Uninsured

-Place Matters

-Who has MediCal?

-Who Gets What Under Health Reform?

-The Culture of Coverage

--HCSA CJ/JJ Initiatives

Who Are the Uninsured?

Ethnicity broken out by percentage

7%

22%

13%

20%38%

LatinoAsianAfrican AmericanCaucasianOther

The Burden of the Uninsured

• Cost are Rising at 5x the rate of wages

• Premiums doubling for all employers every decade

• EMS System Projections

• Market forces and MediCaid Program

• Compromised access to Primary and Specialty Care

Emergency Department Payer Source:Alameda County Acute Care Facilities, 2010

Who Goes Where?

The Affordable Care Act Will Add More Than 200,000 Covered Individuals in Alameda County

0% FPL 133% FPL 400% FPL

MediCaid Expansion The ExchangeEmployer and Individual Mandate

56,000 newly eligible 107,000 eligible for subsidy 35,000 required to purchase or their employer will be required to purchaseApproximately 60,000 Alameda County Residents

will not be insured, even under the most optimistic implementation scenario

The Achilles Health of Health Reform..

Eligibility Doesn’t Mean Enrollment

Enrollment Doesn’t Mean Access

In order to attract providers, we must raise rates. To raise rates, we have to get those eligible enrolled—viability of managed care approach to MediCal depends on the effective eligibility and enrollment models.

CHK is a pilot for us to innovate and collaborate more effectively and prepare for Implementation of the ACA.

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Policy Drivers

Healthy Families to MediCal

1115 Waiver

BMOC

The Inmate Exception

Tax Initiative

Criminal Justice and Health Reform

AB 109

MediCaid Expansion and the Inmate Exception

The Exchange

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HCSA and CJ/JJ Initiatives

JJ Reform: Transition Center, Guidance Clinic, SBHCs, EPSDT

Youth Development: Youth Centers, BMOC, YFOH, Youth Alive, Youth Radio, EMS Corps

FACT, CJ Mental Health, CIT, UMHI, Healthy Oakland

Pipeline Project, Prosperity Project, Place Matters

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