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------=_NextPart_01C63602.2EB7CDB0 Content-Location: file:///C:/DF39BE36/JessicaWaltman_2.22.06_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C63602.2EB7CDB0 Content-Location: file:///C:/DF39BE36/JessicaWaltman_2.22.06_files/slide0001.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" The NAHU Legislative Program and You
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Jessica Fulginiti Waltman
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The Problem of the = Uninsured
nAs many as 45 million Americans  went without health insurance coverage at some point during the last year. nMany of these people did not obtain needed medical care as a result, and all took a significant financial gamble.
n
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Uninsured in Illinois
nAccording to U.S. Census Bureau estimates, = 14 percent of Illinois state residents were uninsured in = 2004, which represents a little more than 1.7 mill= ion people . =
nThat is approximately 1.7 million people.
nOur Nation’s largest football stadium holds = 102,501 people.
nCan you see it filled more than 12        = ;           times over with ju= st uninsured        = ;            Illinois residents= ?
=
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What Constitutes Being Uninsured in America?
nU.S. Census Bureau data is the most widely = cited data on the uninsured.
nAnnual survey of about 78,000 households.
nEach respondent is asked about health insurance coverage in the previous year.
nThose who do not report being covered by private insurance or a government program <= /span>during the past year are reported as uninsured.  =
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Why are the Census = Numbers Challenged?
nThe Congressional Budget Office has challenged the= Census number, saying it may be off by as many as = 10-20 million.
nNumbers are supposed to represent people who were = uninsured at any point during the year.
nMost people are only uninsured for a short while.&= #13;
nNumbers probably more accurately affect the number= of people who were uninsured on any given day. = ;
nAlso, health insurance is a complicated topic, so = the human reporting error rate impacting the data is <= /span>high.
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Why are the Census = Numbers Challenged?
nTwo more recent studies, one by the Urban Institut= e and one by the Actuarial Research Corporation both found that the Census data may overestimate the number of America= n uninsured.
nThe Urban Institute study used data from 2001, 200= 3 and 2004, and it concluded that the Census surveys mig= ht have overestimated the = number of uninsured by up to 4 million people.
nAn analysis by the Actuarial Research Corporation focused on 2003, and conclude= d that 9 million, or 20 percent, of the 45 million people identified by the U.S. Census Bureau as uninsured in 2003, actually did have health insura= nce coverage.
nBoth concluded that an undercount of Medicaid reci= pients was likely the reason= for the discrepancy
n
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How Long Are People Uninsured?
nFor most people = being uninsured is a temporary situation. nSimil= ar to unemployment, although the numbers are higher because children = are impacted too, not all employers offer coverage, and for th= ose that do, workers may face a coverage lag when they start a job.
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How Long Are People Uninsured?
nAccording to the CBO:
= 211;45 percent are uninsured for 4 months or less
&= #8211;71 percent obtains coverage within 1 year
&= #8211;84 percent obtain coverage within 24 months
= 211;Only 16 percent go without coverage for 2 years or more
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Who Are the Uninsured?
nEducation and income level have been shown to impact insurance status.
nHigher levels of bo= th equal a higher likelihood of being insured.
nRace is a factor. 
nHispanic families h= ave the highest national uninsured rate at 32.7 percent.
n<= span style=3D'mso-special-format:lastCR;display:none'>
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Who Are the Uninsured?
nOne of the most interesting facts about the uninsured is that the vast majority of them are part of working families.
nThe CBO estimates that 90 percent of those = uninsured in 1998 were part of families where at least one person worked either full or part-time.
n75 percent of these people did not have access to employer-sponsored health = insurance coverage
nRemainder declined coverage
n
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How Much Does Cost Impact Cover= age?
n71 percent of all non-elderly uninsured indicate cost in the main reason the= y do not have coverage n97.5 percent of those who went without coverage for 1 year or more indicate cost is the driving factor&= #13;
n
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How Much Does Cost Impact Cover= age?
nThe second-most cited reason for lack of health insurance was the lack of employer-sponsored coverage.
nThis problem also relates directly back to cost.&#= 13;
nThis factor can also be directly attributed to cos= t, as research shows that cost has forced many small businesses to either drop their coverage or requir= e much greater cost-sharing by employees.
nFrom 200-2004, the percentage of employers with 3-1999 employees that offered coverage dropped from 68 to 63 percent.
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What’s Being Done to= Address the Problem?
nThe claim is frequently made that the US is the only major industrialized country to not provide <= /span>universal access to healthcare for its citizens= 3;
nFederal government spends more than 99 billion per year to provide coverage to the uninsured
nMeans of providing coverage include:
–<= /span>Emergency rooms
–<= /span>Medicare
–<= /span>Medicaid
–<= /span>SCHIP
–<= /span>HCTC Tax Credit
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State-Level Spending
nMedicaid
nExpansions of Medic= aid (i.e. Medical Assistance to Workers with Disabilities)
nSCHIP
nMany smaller state programs that target low-income people and people with specific health conditions
nCounty and Local He= alth Departments
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Helping the Uninsured
nFocusing resources in the right direction
&= #8211;Small business owners
= 211;Low-income individuals who have access to employer-based coverage
&= #8211;Focusing on the private market
nKeeping the state’s health insurance market vibrant and competi= tive
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About the HCOD
nThe HCOD contains information about private health insurance coverage, as wel= l as the many public and private programs <= /span>available to Americans to help them obtai= n the medical care they need. <= /span>
nPolicymakers, the media and other = interested parties can also use the Datab= ase as a means of comparing health care coverage options for Americans on a state= -by-state basis
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Creation of the HCOD
nThe National Association of Health Underwriters (NAHU), a professional associa= tion of more than 20,000 health insurance agents, brokers and benefit specialists, is extrem= ely concerned about the problem of the uninsured.
nTo help addr= ess this problem, we have developed the Health Care Coverage Optio= ns Database (www.nahu.org/consumer/health= care).
nHCOD is an on-line tool to help make American health care consumers aware of= all of the coverage options available to them.
n
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Inside the HCOD
nThe database includes searchable details about each state’s:
–<= /span>Employer-based markets
–<= /span>Options after the loss of group coverage
–<= /span>Individual health insurance market
–<= /span>Coverage options for Medically Uninsurables
–<= /span>Medicaid program
–<= /span>SCHIP Program
–<= /span>HCTC Program
–<= /span>State-Specific Programs
–<= /span>National Coverage Options (Veterans Health, Medicare, etc.)
–
–
------=_NextPart_01C63602.2EB7CDB0 Content-Location: file:///C:/DF39BE36/JessicaWaltman_2.22.06_files/slide0031.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" The NAHU Legislative Program and You
Using the HCOD
nDatabase can be used to:
= 211;Compare state laws and requirements regarding health insurance coverage&= #13;
= 211;Compare state’s means of covering the uninsured
–Review the details of state specific programs
&= #8211;Help consumers find coverage options
------=_NextPart_01C63602.2EB7CDB0 Content-Location: file:///C:/DF39BE36/JessicaWaltman_2.22.06_files/slide0006.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" The NAHU Legislative Program and You
How Real People Can Use the HCOD
nJames, = Age 58, Unemployed Factory Worker
nLaid-of last year when his plant shut down and moved to Mexico.
nPreviously h= ad employer-sponsored coverage, but uninsured si= nce job loss. 
nSpouse has employer-based coverage, but cost of adding h= im to the polic= y is too great.
nIn generally good health, but has chronic asthma.
nOther employ= ees from his old job tell him he might be eligible = for federal heal= th insurance purchasing assistance in the form of a tax cre= dit, but he’s not sure how that would work. 
n<= span style=3D'font-family:Tahoma;mso-ascii-font-family:Tahoma;mso-bidi-font-fam= ily: "Times New Roman";mso-hansi-font-family:Tahoma;font-size:64%;mso-special-f= ormat: lastCR;display:none'>
<= ![if !vml]>3D"US
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How Real People Can Use the HCOD
nJames Can Use the HCOD to= :
nLearn more a= bout the federal Health Care Tax Credit, created by the Trade Adjustment Assistance Act of 2003.  As a displaced worker, he might be able to ge= t an advanceable tax credit to help him purchase coverage through = his wife’s employer plan or through a state-elected option.
nFind out abo= ut individual market coverage and how his preexisting condition (asthma) might impact the coverage he can buy. 
nInvestigate = what his state’s option is for purchasing individual coverage if = you have a serious medical condition that might render you uninsurable.
nLook into ho= w an insurance carrier must cover his asthma if he obtains a new job and gets group health insurance benefits, or if he decides to join his wife’s group plan.
nCheck out any other state or national healthcare assistance programs for which he or his family members might be eligible.
n<= span style=3D'font-family:Tahoma;mso-ascii-font-family:Tahoma;mso-bidi-font-fam= ily: Arial;mso-hansi-font-family:Tahoma;font-size:63%;display:none'>
n <= /div>
------=_NextPart_01C63602.2EB7CDB0 Content-Location: file:///C:/DF39BE36/JessicaWaltman_2.22.06_files/slide0008.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" The NAHU Legislative Program and You
How Real People Can Use the HCOD
nMarah, = Age 32, Administrative Assistant
nMarah is a single mother of two young children.
nShe makes $33K a year at a firm with 18 employees. 
nHer employer pays for her health <= /span>insurance benefits and 50% of her = dependent benefits.
nShe is struggling to pay her share of her children’s premiums.
nShe was offe= red another job with a different firm that pays more,= but she would not have access to their health benefits for= at least three months.  <= /span>This makes h= er nervous because her son was recently diagnosed wit= h a kidney disorder. 
n<= span style=3D'mso-hansi-font-family:Tahoma;font-size:64%;display:none'>
n
<= ![if !vml]>
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How Real People Can Use the HCOD
nMarah Can Use the HCOD to= :
nInvestigate the requirements for, and benefits of = participation in, the State Children’s Healt= h Insurance Program, which could help Marah obtain <= /span>low-cost health insurance coverage for her childre= n.
nFind out what her options are for continuation of = group coverage if she changes jobs and temporarily= does not have access to employer-based health insurance.
nCheck out state and national healthcare assistance= programs, like the American Kidney Fund’s Pa= tient Assistance Programs, which could help her obtain <= /span>needed low-cost treatment for her son.
------=_NextPart_01C63602.2EB7CDB0 Content-Location: file:///C:/DF39BE36/JessicaWaltman_2.22.06_files/slide0010.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" The NAHU Legislative Program and You
How Real People Can Use the HCOD
nAndrew, Age 28,&#= 13;
nLegislative Assistant
nAndrew works for a member of the state legislature.
nAndrew’s boss is very interested in potential Medicaid reform ideas. =
nAndrew also has to frequently answer letters, = emails and phone calls from constituents who are having trouble accessing healthcare coverage, and he could use a way to better assist them.
  &= nbsp;          &nb= sp;            =             &nb= sp;          
3D"David
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How Real People Can Use the HCOD
nAndrew can use the HCOD to:
nCompare the structures of Medicaid programs across= the states, including asset, i= ncome and resource requirements, benefits, enrollment and other eligibility requirements, costs, and contact information.
nSee how his state’s Medicaid requirements st= ack-up with those in other states, and check to see if any states have developed  program innovations that could be copied in his state.
nLearn about the legal requirements governing the state’s private health insurance markets.  Compare t= hem to other states and ascer= tain if the requirements have any impact on coverage.
nGet information about state-specific healthcare co= verage assistance programs, as well= as national assistance programs, to pass along to constituents.
nReference contact information for state and federal regulators of priv= ate health insurance and medical coverage assistance programs. <= /div>
------=_NextPart_01C63602.2EB7CDB0 Content-Location: file:///C:/DF39BE36/JessicaWaltman_2.22.06_files/slide0012.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" The NAHU Legislative Program and You
How Real People Can Use the HCOD
nJane, A= ge 60, Small Business Owner and State Legislator
nMember of the state legislature where she serves on a committee that has= jurisdiction over health insurance issues.
nVery interes= ted in individual and small group market reforms and also = the state Children’s Health Insurance Program.
nHer husband,= age 61, recently took early retirement to buy a small bookstore.
nCurrently on COBRA through spouse’s former employer.
nWould like to look into what would be involved to purchase small gro= up health insurance coverage for herself, spouse and store employees.
&n= bsp;      = ;            &n= bsp;      
<= ![if !vml]>
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How Real People Can Use the HCOD
nJane can use the HCOD to:=
nFind out detailed information about her state̵= 7;s including enrollment and i= ncome requirements, benefits, and cost information.
nCompare the benefits and structure with those util= ized in other states.
nContact other state Children’s Health Insura= nce Programs to share ideas= and obtain information.
nHelp constituents get information about state-spec= ific healthcare coverage assistan= ce programs, as well as national assistance programs like Medicaid and others.
nReview the health insurance coverage requirements = for small business owners i= n the state. 
nEasily reference contact information for regulator= s of private health insur= ance and medical coverage assistance programs in other states and at the federal level.
n<= span style=3D'font-size:63%;display:none'>
n
------=_NextPart_01C63602.2EB7CDB0 Content-Location: file:///C:/DF39BE36/JessicaWaltman_2.22.06_files/slide0014.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" The NAHU Legislative Program and You
How Real People Can Use the HCOD
nKevin, = Age 46, Independent Health Insurance Agent
nKevin is the owner of a small health insurance agency.
nHe specializes in selling health <= /span>insurance and other employee benefit products to other small business owners.
nHe represents everyone from sole <= /span>proprietors to employers of up to = 500 individuals, and he also sometimes sells health insurance <= /span>products to individuals who wan to purchase it on their own, <= span style=3D'position:absolute;top:82.25%;left:56.36%;width:41.01%;height:4.25= %'>