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Joint Board of Health <br />Board of County <br />Commissioners Meeting <br />October 12, 2010 <br />Slides Courtesy of <br />NC Institute of Medicine <br />Overview of "Health Care Reform" <br />- Opportunities provided by the Patient <br />Protection and Affordable Care Act (ACA) <br />^ Underlying reasons for health reform <br />^ Coverage expansion <br />'_` Qther ACA provisions <br />Prevention and Wellness <br />• Cost containment and financing <br />3 <br />Overview Elements <br />- By 2014, the bill requires most people to have <br />health insurance and large employers (50+ <br />employees) to provide health insurance--or pay a <br />penalty. <br />• Builds on our current system of public coverage, <br />employer-sponsored insurance, and individual (non- <br />, ,.group) coverage <br />-- - New.furiding for prevention, expansion of the <br />health`workforce, long-term care services, <br />~.- increasing the healthcare safety net, and <br />'' improving quality <br /> <br />Why Focus on Population <br />Health? <br />- North Carolina ranks 37~ in overall health status <br />and 40~ in premature deaths in 2009 (with "1" <br />being the state with the best health status). <br />- North Carolina ranks in the bottom third for many <br />heath indicators including: <br />• A~lults.who are current smokers (37'^) <br />• ©bese.adults (41~ <br />• Air pollution (36r^) <br />•~ 4-gear graduation rate (37~^) <br />-°North Carolina can not "treat" its way to health <br />Underlying Reasons <br />- Estimates of the uninsured: <br />• Recent Census numbers showed approximately 1_7 <br />million non-elderly uninsured in NC (2009) <br />^ 2~/0 of Orange County adults under 65 uninsured <br />- Lack of health insurance impacts on a person's <br />health` - <br />• ?ec9ple"ivho are uninsured are less likely to receive preventive <br />se+vice5-more likey to end up in the hospital for preventable <br />cor~dikions or late stage cancer, and more likely to die <br />prematurely <br />,u Lack of insu2nce coverage affects a family's financial security <br />s•u2.: us c«~. H..^, wv..e. ew.n.y. sma,s.,,e type ei ceve<.9. <br />ey st„~r•ron• una•r ~. r•a. nwa. <br />Expansion of Public Programs <br />- Expands Medicaid to cover all low-income people <br />under age 65 (including childless adults) with <br />incomes up tp 133% FPL (begins FY 2014) ~s~ zooi, <br />zaoz) <br />• States must maintain current income eligibility for <br />children in Medicaid and CHIP until 2019 cs«. arouo~, ro zap. <br />• Beginning 2014, special outreach requirements to <br />' vulneraple populations (sauoi} <br />Enhances Medicare preventive services <br />2 <br />1 <br />