Sep 10, 2015 - and Enrollment: Strategies to Engage LGBTQ. Communities of Color ... programs on the basis of race, color
Targeted ACA Outreach and Enrollment: Strategies to Engage LGBTQ Communities of Color Xavior Robinson, NASTAD Katie Keith, Out2Enroll Ikeita Cantu Hinojosa, DC Health Benefit Exchange Brandon Armani, Us Helping Us United States Conference on AIDS September 10, 2015
About NASTAD NASTAD’s mission is to strengthen state and territory-based and global leadership, expertise and advocacy and bring them to bear in reducing the incidence of HIV and viral hepatitis infections and on providing care and support to all who live with HIV and viral hepatitis. NASTAD's vision is a world free of HIV/AIDS and viral hepatitis.
ACA: Three Prongs
Public insurance reforms Private insurance reforms Health infrastructure reforms
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Medicaid expansion Medicare Part D reforms
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Marketplaces Prohibitions on discriminatory insurance practices
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Investments in community health centers, health workforce, coordinated care, and prevention
ACA Nondiscrimination Provision Section 1557 of the Affordable Care Act prohibits discrimination in health care programs on the basis of race, color, national origin, sex, sex stereotypes, gender identity, age, or disability. o Health insurers, hospitals, the health insurance exchanges, and any other entities that receive federal funds are covered by this law. It became effective upon passage of the ACA.
HRSA/HAB Policies and ADAP Insurance Purchasing • The Ryan White HIV/AIDS Program is the payer of last resort and grantees must “vigorously pursue” client eligibility for public and private insurance o Grantees may not dis-enroll clients from services for failure to enroll in public or private insurance coverage
• HRSA encourages state ADAP/Part B Programs to use their Ryan White funding to help clients access insurance, as long as: o Formulary includes at least one drug in each class of core ARVs from the HHS Clinical Guidelines o It is cost-effective in aggregate as compared to purchasing medications
• Other Ryan White Program grantees may also use their funds to help clients with the cost of insurance • Ryan White Program funds may be used to cover services not covered or inadequately covered by public and private insurance
ADAP/Part B Programs Currently Purchasing Qualified Health Plans (QHPs) for Clients (September 2015) VT WA
ME
ND
MT
NY MA
MN
OR
WI
SD
ID
RI
MI
WY
NV CO
KS
IN
DE
WV
MO KY
AZ
OK NM
NJ
OH
IA IL
CA
CT
PA NE
UT
NH
VA NC
TN AR
MD
DC
SC GA MS
AL
AK TX
LA FL
HI
ADAP supporting QHP premiums, and prescription drug copayment and coinsurance
ADAP supporting QHP premiums
ADAP supporting QHP prescription drug copayment and coinsurance
ADAP not currently supporting QHPs
ADAP Insurance Enrollment National ADAP Client Insurance Status as of 3/31/151 (n=190,000) 27%
62%
QHP
Expanded Medicaid
11%
Full Pay Medication or other insurance assistance
ADAP Insurance Enrollment 68,000 Total Transitions
48,000 Qualified Health
25,000 Total Transitions
Plan Transitions
12,000 Qualified Health
13,000 Medicaid Transitions
2015
2014
Plan Transitions
20,000 Medicaid Transitions
2016
20,000 Medicaid Transitions
Impetus for Targeted Outreach and Enrollment
1. Build upon previously successful strategies and utilize existing networks 2. Seek tribal consultation and consult with minority communities 3. Adopt a grassroots approach 4. Ensure culturally appropriate messaging and information
