OVERVIEW

On Tuesday, March 23, 2010, President Barack Obama signed the Patient Protection & Affordable Care Act (HR 3590), followed by the signing of the Health Care and Education Reconciliation Act of 2010 (HR 4872), on Tuesday, March 30, 2010.


The low-income and uninsured patients of community clinics and health centers will see an enormous benefit from the passage of this landmark legislation.  Click on the links below to access more information about each of the important issues that will be impacted by health care reform.

 

WORKFORCE

CPCA Releases New Health Workforce Report - Details Key Opportunities for California

The California Primary Care Association (CPCA), which represents community health centers who serve 1 in 7 Californians, is pleased to share our new report titled “Horizon 2030: Meeting California’s Primary Care Workforce Needs.”

Horizon 2030 offers a sobering analysis of California’s primary care workforce today while detailing key opportunities to meet the workforce needs of tomorrow. The findings of this report provide a stark reminder that the primary care workforce shortage has reached a critical point and will continue to devolve if California doesn’t take immediate steps to address our unmet needs. To get California back on track, Horizon 2030 provides a clear roadmap that is full of common sense solutions.

 

OUTREACH AND ENROLLMENT RESOURCES

October 1,2013 is just around the corner, are you ready to enroll?  On this webpage, CPA has provided important resources to support you in securing funding, maximizing resources, and creating a plan to educate, outreach, and enroll the communities you serve.

 

MANAGED CARE CONTRACTING

Many uninsured health center patients will reap the benefits of the Affordable Care Act by enrolling in health insurance in 2014.  Health centers who hope to continue serving newly insured patients will need to negotiate contracts with managed care plans in both Medi-Cal and in the Exchange.  CPCA has collected and created a variety of tools to help CCHCs in the managed care contracting process.  Click here to visit the managed care contracting page.

 

 MEDICAID EXPANSION

The Affordable Care Act (ACA) includes an expansion of Medicaid to individuals, including childless adults, up to 133% FPL with full federal funding for the first three years.  

 

COVERED CALIFORNIA (California Health Benefit Exchange)

California’s Health Benefit Exchange, “Covered California,” will offer low-cost, subsidized commercial health insurance to individuals and small business starting January 1, 2014.    

 

NEW FUNDING FOR HEALTH CENTERS

The ACA authorizes $11 billion in new funding for the Health Centers program over five years.   $9.5 billion of this funding will allow health centers to expand their operational capacity to serve nearly 20 million new patients and to enhance their medical, oral, and behavioral health services, $1.5 billion of this funding will allow health centers to begin to meet their extraordinary capital needs, by expanding and improving existing facilities and constructing new sites. 

 

PUBLIC HEALTH AND PREVENTION

The ACA includes a variety of prevention programs that impact CCHC patients. 

 

HEALTH CARE REFORM LEGISLATION

CPCA staff is actively tracking state health reform legislation.  

 

HEALTH CARE AMBASSADOR PROGRAM

The time has come for you to seize the moment and be part of history. You can accomplish this by becoming a Healthcare Ambassador!! It entails understanding the simple and basic points of the new health care law. 

 

CURRENT ADVOCACY

CPCA Submits Comments on DHCS’ Mental Health and Substance Use Services Needs Assessment and Service Plan

(Volume 2)

CPCA submitted comments on behalf of our members for the DHCS’ Mental Health and Substance Use Services Needs Assessment and Service Plan last Friday.  The DHCS draft will inform the implementation plan currently being crafted, which will determine the expansion of mental health and substance use services.  Click here to view a copy of CPCA comments.  If you have additional comments or concerns regarding the mental health and substance use expansion and would like to discuss, please contact Erynne Jones at ejones@cpca.org.

 

CPCA Submits Comments on Medicaid, CHIP, Exchange Proposed Rule

On February 21, CPCA submitted comments to CMS on the recently released proposed rule “Medicaid, Children’s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing.” Please click here for our final comments.

In other federal regulatory news, CMS yesterday released a final rule titled “Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation.” CPCA staff will be reviewing the rule and will be available to answer any questions. Information will be posted to the Health Care Reform section of CPCA’s website next week. The final rule can be viewed here. 

 

RESOURCES

MCAP Update - October 11, 2016

April 15, 2014

All County Welfare Director Letters (ACWDL 14-03 and 14-03E) – 2014 Renewals: Converting pre-ACA Medi-Cal Beneficiaries to MAGI Medi-Cal

September 30, 2013

CPCA is excited and looking forward to the next phase of the implementation of the Affordable Care Act, or Obamacare, where millions of Californians are expected to get coverage. However, many Californians will remain uninsured while others will be part of mixed status families, those who can get insurance will be treated while other family members will delay visiting the doctor due to lack of health insurance. CPCA has developed this FAQ to help farmworkers, immigrants and the undocumented through this new phase.

 

Materials from the September 26, 2013 HCR Brown Bag Webinar

  • HCR Brown Bag Webinar Presentation
  • Recording of Webinar (33 minutes)
  • CPCA Enrollment FAQ

 

Materials from the June 27, 2013 HCR Brown Bag Webinar

  • HCR Brown Bag Webinar Presentation
  • Recording of Webinar (49 minutes)
  • Written Answers to the Webinar Q&A

 

Other Presentations on Health Care Reform

  • CPCA Presentation on the Health Benefit Exchange
  • Covered California: Opportunities for Community Clinics and Health Centers Presentation
  • Covered California: Policies, Guidelines, and Relationship with Community Clinics and Health Centers Presentation
  • Community Clinics and Health Centers: Implementing Federal Health Care Reform Presentation
  • Community Clinics and Health Centers: Implementing Federal Health Care Reform Updated Presentation
  • Eligibility for Health Care Coverage in 2014 - June 2013 Ambassador Program Webinar Presentation
  • Preparing for Open Enrollment - July 2013 Ambassador Program Webinar Presentations Covered California Outreach & Education Grant Program Preparing for Open Enrollment Health Reform: Covered California and the Medi-Cal Expansion How Do We Get Our Community and Our Patients From Here to There?
  • Covered CA Total CEE Production (6-5-2014)
  • Letter to Covered CA on Out of Network Benefits (5-12-2014)
  • Letter to CCIIO on Out of Network Benefits
  • Covered California Letter to CPCA on Out of Network Benefits
  • 1557 NPRM Proposed Rule on Nondiscrimination in Health
  • Primary Care Workforce Study

NEW! CPCA Fact Sheets

  • What is a Medi-Cal Managed Care Plan?
  • How Will Health Reform Affect Me?
  • What is Health Care Reform?
  • What Insurance Will I Have in 2014?

NEW!  Template Letter to Send to Patients Explaning the Move to Managed Care

 

“Healthcare Coverage in 2014: Five Things Californians Should Know” Booklet

Californians for Patient Care recently released its consumer enrollment booklet on the Affordable Care Act.  The easy-to-read booklet, “Healthcare Coverage in 2014: Five Things Californians Should Know,” offers tips and information to help people understand what the new health law means for them and their families as they prepare for the first open enrollment on Oct. 1, 2013. A Spanish version of the booklet is also available and can be downloaded by clicking here.

 

California HealthCare Foundation - Center for Health Reporting

Ask Emily:  Answers to Consumer Questions about Obamacare - by Emily Blazer

 

Center on Budget and Policy Priorities

  • Fact Sheet:  "Health Reform Beyond the Basics: Premium Tax Credits" - May 2013

 

NACHC Releases Three New Issue Briefs

Three new Issue Briefs were released on key topics for state policy makers:

  • Health Insurance Exchanges: Key Issues for Community Health Centers provides analyses of the major policy issues impacting FQHCs for the different types of exchanges.
  • Medicaid Premium Assistance and Health Insurance Exchanges addresses some of the most common questions that have been raised in two parts: an overview of the different Medicaid eligibility groups and coverage and benefits they are entitled to, and a discussion on how Exchanges will likely interact with Medicaid under the Arkansas proposal, which is being used as the model.
  • State Fiscal Year 2013 Funding for Community Health Centers: Funding Levels Remain Inadequate Amidst Signs of Leveling Off Cuts shows that 29 states appropriated $287 million for the state fiscal year 2013, a 14% decline from last year.

 

Kaiser Family Foundation Brief Examines Key Lessons For Outreach and Enrollment in Coverage Under Health Reform

The Affordable Care Act (ACA) will increase coverage options through an expansion in Medicaid and new health insurance exchange marketplaces, but effective outreach and enrollment efforts will be key for translating these new opportunities into increases in coverage.

A new issue brief from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured identifies five key lessons for such efforts based on a review of existing research on previous outreach and enrollment experience in Medicaid and the Children's Health Insurance Program.


The paper, Key Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act, is part of the Getting Into Gear for 2014 series examining key implementation issues as states prepare for the ACA coverage expansions. Other installments in the series include webinars on the role of application assistance in translating the Medicaid expansion into increased coverage, and profiles of innovative Medicaid and CHIP renewal initiatives, as well as case studies of innovative initiatives in Utah and Michigan, respectively.

 

New In-Language Webinars and Materials – “The Health Care Law an You”

“The Health Care Law and You” is a presentation developed by the U.S. Department of Health and Human Services to educate community members about the benefits of the Affordable Care Act. This resource has been translated by the Office of Public Engagement at the Centers for Medicare & Medicaid Services into the following languages: Chinese, Korean, Vietnamese, Tagalog, Hindi, Bengali, Hmong, Khmer, Samoan and Tongan.  Sponsored by the Asian & Pacific Islander American Health Forum and the Centers for Medicaid and Medicare, this webinar will feature Professor Furjen Deng Ph.D., Department of Sociology, Sam Houston State University and Light and Salt Association, Board Chair, who will speak about how the Affordable Care Act will increase health care access and reduce health care disparities.

This is the first in a series of in-language webinars that will include Chinese (Mandarin), Korean, Tagalog, Tongan and more.


You can also download the slides in Chinese, Korean, Vietnamese, Tagalog, Hindi, Bengali, Hmong, Khmer, Samoan and Tongan at http://www.apiahf.org/policy-and-advocacy/health-care-reform-resource-center/in-language-resources . Please click here to register.

 

New Tool to Help Consumers Understand the Premium Tax Credit

Consumers Union, publisher of Consumer Reports, has developed a new brochure to help explain the new health insurance premium tax credit to consumers. The brochure was tested with consumers to ensure that it provided information in a way that gave users a general picture of their eligibility and inspired them to apply if they did qualify. Tools like this brochure will be critical to educating the millions of Americans who still do not know about this opportunity to make health insurance affordable through the premium tax credit.

 

Ways that Community Health Centers Can Increase Outreach and Enrollment

The Michigan Primary Care Association has put together a "playbook" that lays out, step by step, how health centers can gear up to play a major role in outreach and enrollment this fall. Read our blog to learn more about this great resource.

 

Kaiser Family Foundation:  Updated Calculator Shows Subsidies Available in 2014

With open enrollment for health insurance exchanges less than six months away, the Kaiser Family Foundation has updated its health reform subsidy calculator to illustrate how government subsidies, designed to help with the cost of insurance premiums, will work under the Affordable Care Act (ACA). Beginning in 2014, tax credits will be available for moderate-income people under age 65 who are not covered through their employer, Medicare, or Medicaid, and instead purchase coverage on their own in a health insurance exchange (also known as an insurance "marketplace"). The updated calculator is just one of the interactive tools available on the Kaiser Family Foundation's newly redesigned website. The website also provides summaries, explanations and analysis of the health reform law and its impact, as well as polling data, relevant research, and news from Kaiser Health News, the editorially independent news service established by the Foundation.

 

Health Care Ambassador Program webinar:  What to Tell Your Patients About Eligibility for Health Care Coverage in 2014 - April 17, 2013 Starting on January 1, 2014, almost everyone will need to have health insurance. Fortunately, Health Care Reform makes it easy and affordable to find coverage! People will still have the opportunity to get health insurance through their work if their employer chooses to offer insurance. For people who do not have job-based insurance, there will be a cheap and easy coverage available for individuals and families. This presentation provided a basic overview of the new coverage options that will be available under health care reform and provided a question and answer session to ensure that everyone is ready to talk to patients about coverage!

  • Presentation slides (pdf)
  • Webinar recording (1 hour, 14 minutes)
  • Webinar Q & A
  • Fact Sheet: Employer coverage requirements and taxes under the Affordable Care Act (Ernst & Young - October 2012)
  • Fact Sheet: Three Years of the Affordable Care Act (Health Access - March 21, 2013)
  • Flyer: Explore Current Health Care Options (includes English and Spanish versions)
  • Covered California Website - for various fact sheets in multiple languages

 

FREE On-Demand Webinar: Potential Impacts of the Affordable Care Act on Safety Net Providers in 2014

The Health Resources and Services Administration is offering a FREE on-demand webinar titled “Potential Impacts of the Affordable Care Act on Safety Net Providers in 2014.”  This webinar provides an overview of the various provisions of health care reform and how it will effect health centers as providers, as employers, and as a part of the overall health care delivery system.  http://services.choruscall.com/links/hrsa130403.html

 

Community Health Center Responsibilities to Provide Employee Coverage under the ACA

Community Clinics and Health Centers (CCHCs) will be greatly impacted by Health Care Reform not just as providers, but as employers.    It’s important to remember that even non-profit employers with 50 or more full-time equivalent employees are required to offer affordable health insurance to their employees or pay a penalty to help cover the cost of making insurance affordable for their employees through Covered California.

IRS guidance defines full-time employee as any employee working on average at least 30 hours a week (as well as some “variable-hour employees”).   Nonprofit employers who fail to provide coverage to their full-time employees are subject to a penalty of $2,000 per year (assessed on a monthly basis) multiplied by their total full-time employee count, minus the first 30 workers.  To learn more, CPCA recommends a guide created by Ernst & Young, available here.

For questions regarding the ACA, please contact Meaghan McCamman at mmccamman@cpca.org.  

 

Enrollment Assisters Fact Sheet - Enroll America (April, 2013)

 3 Years of the Affordable Care Act - Health Access Report (March 21, 2013)

TCE Obamacare Flyer - English

TCE Obamacare Flyer - Spanish

 Resources

  • CPCA letter to DMHC Regarding Centene-Health Net
  • CPCA letter to CDI Regarding Centene-Health Net
  • January 2016 Memo on Mergers CPCA letter to DMHC Regarding Aetna-Humana CPCA letter to DMHC Regarding Anthem-Cigna CPCA letter to CDI Regarding Anthem-Cigna CPCA letter to DMHC regarding undertakings in Anthem-Cigna negotiations CPCA letter to Blue Shield

For more information about health care reform, contact Meaghan McCamman at mmccamman@cpca.org or (916) 440-8170.


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