As a nonpartisan organization, we do not endorse specific candidates, nor do we tell you how to vote on the issues coming before you on November 6. But we can ask you to separate myths from facts as the debates touch on health reform and Medicare—and to help your friends and neighbors do the same. Here are tools for doing just that.

What you can do:

• First, review the uncanny similarities between RomneyCare and ObamaCare.  So why all the fuss?  If you think the Affordable Care Act (ACA) is a reasonable first step in a multi-year process of reform, you’re in good company.  There was a time, only 4 years ago, when Utah leaders felt the same way. That’s how Utah came to be the second state in the nation to build a health insurance exchange (now called Avenue H, in part to distance the state’s exchange from ACA exchanges). All of that happened before health reform became a political blood sport.
• Check out this YouTube video about the ACA and what’s in it: http://www.youtube.com/watch?v=3-Ilc5xK2_E.
  • Bonus step: post it to FaceBook or tweet about it!
  • Here’s the same video en español: http://www.youtube.com/watch?v=FAf2H3pFtzs&feature=relmfu
• Read here about what’s at stake in the November election for health reform and the future of Medicare.
• Separate myths from facts in candidates’ remarks on Medicare and the ACA…

Myth: Romney-Ryan proposes no cutbacks for current Medicare beneficiaries.

Fact: R-R cuts prescription benefits for seniors and people with disabilities with high medical costs and eliminates free preventive services like annual check-ups and mammograms.

Myth: ObamaCare’s $716 billion cuts to Medicare will take away senior’s benefits.

Fact: Actually no benefits will be touched—the cuts to Medicare’s budget result from reducing waste, fraud and abuse currently rooted in the insurance and pharmaceutical industries. Read more about the Romney-Ryan plan for Medicare.

Myth: 20 million people will lose health insurance under ObamaCare.

Fact: Actually the Congressional Budget Office states ObamaCare will bring health coverage to over 30 million of the 50 million Americans now uninsured, whereas R-R proposals will increase the uninsured to 78 million in 10 years.

Utah’s decision about whether to go forward with the Medicaid expansion may be the most critical decision of the 2012 Legislative Session.  Saying YES brings affordable health insurance to over 100,000 Utahns.  Refusing the expansion means denying the possibility of coverage to the most vulnerable Utahns and missing out on over $4 billion in federal funds over the next 5 years.  Then there’s the economic impact that goes with this level of federal spending in the state. These funds will support or create jobs in the health care sector, and those jobs generate enough economic activity to justify the minimal cost to the state.

Governor Herbert will wait until after the election to make his decision on whether to include the expansion in the state budget.  But, when pushed on the issue, he voiced strong concerns with the expansion and many other aspects of the Affordable Care Act.   With the election season in full swing, we can count on our leaders to make strong remarks on hot button issues like this. But Utah is fortunate to have a governor who, despite his concerns, is open to reason and data.  That’s where you come in! Utahns for the Medicaid Expansion are confident that, once myths are dispelled and accurate state cost estimates are developed, the choice to move forward will be clear.

What we think
What will it take to convince Utah leaders to expand Medicaid? It will take the sort of courage and risk taking that was everywhere in evidence at the October 4^th Social Services Appropriations Subcommittee Hearing (to listen to the audio, fast forward by 70%) on the Medicaid expansion!

Together the doctors, uninsured Utahns, nurses, Medicaid consumers, and health policy experts spoke up and made a compelling case for the Medicaid expansion!  All 18 speakers delivered powerful testimony about expanding Utah’s Medicaid program, highlighting its importance in promoting insurance coverage and preserving Utah’s good public health.  Several speakers spoke strongly about how Utah Medicaid helped them bridge to a better place in life, how it helped then become healthy enough to get a good job…with insurance…which enabled them to contribute to their communities. Others spoke about how a medical condition, combined with the lack of insurance coverage, led to a black hole of financial troubles and poor health.  The hearing helped set the stage for this very important ongoing community dialogue about the Medicaid expansion and why it’s a good investment for Utah.

Hats Off to the courageous folks who testified at the Oct. 4 Medicaid expansion hearing!

What you can do next

• Share more stories! No matter what your standpoint (uninsured, Medicaid consumer, provider, advocate, concerned citizen, clergy), the best way to educate the public and decision makers about the Medicaid expansion is by telling personal stories.  If you or one of your friends or relatives has a story about how Medicaid helped, or could have helped, you get cost-effective care or stay out of the emergency room, please get in touch with Matt Slonaker (Medicaid Policy and Collaborations Director) at matt@healthpolicyproject.org  or call (801) 433-2299.
• Stand Up for the Expansion!  If you belong to a group that supports, or could support, the Medicaid expansion in Utah please fill out this form. This form allows the U4ME to make the most of our collective skills and interests.
• Check out this new messaging tool from Community Catalyst: “Medicaid Expansion Messaging for State Advocates.”  Use this tool as you prepare for your face-to-face meetings with Utah policymakers.
• Join forces with Utahns for the Medicaid Expansion (U4ME), an 80+ member (and growing!) coalition dedicated to a coordinated campaign for the expansion.  If you like what you heard at the recent hearing, it’s thanks in great part to the careful preparations of the U4ME.  Almost all of the eloquent testimony came from or was recruited by U4ME members! To be part of this up and coming, unstoppable organizing effort, email matt@healthpolicyproject.org for the schedule.
• AND like us on Facebook.

Take Care Utah, the UHPP-based consumer health assistance program, is moving at a fast clip.  We had our second Tool Kit Training on Sept. 18^th (Chilean Independence Day, we might add) which was very successful according to the feedback we received through our survey. We have been asked to give the same training for the Mountainland Head Start and for the Children’s Service Society. According to that same survey, the topic that people would most like to be trained on is the Affordable Care Act!

We also visited our friends at the Refugee & Immigrant Center/Asian Association of Utah, and trained them on the Affordable Care Act and how it will affect their work with newcomers to Utah.

We want to remind all of you of Take Care Utah’s key purpose: to build the “no wrong door” network of organizations that are equipped to help people enroll in health insurance. The “No Wrong Door” approach will build on the health care assistance already available in Utah by sharing best practices around the state.  Network members share tools and information so we can help all Utahns benefit from the coverage opportunities available now and in 2014.

What you can do:

• We are now forming the TCU advisory committee to help guide the next critical developmental phases of TCU.  If you or your organization would like to serve on this committee, please send email to Randal Serr, TCU Director: randal@healthpolicyproject.org. In your email, please describe the populations you serve and what you or your organization can bring to TCU’s No Wrong Door approach to enrollment and consumer health assistance.
• Request an enrollment or ACA training. If your organization would like to be trained on enrollment or Federal Health Reform, let us know and we will gladly partner with you and your colleagues.
• Like TCU on Facebook or follow us on twitter (@TakeCareUtah).

The Supreme Court upheld most of the Affordable Care Act last June. That means that starting in 2014 most Americans finally will have affordable options for health insurance coverage. What is less clear is whether low-income adults will enjoy that same access. That is because the Supreme Court left to the states the decision of whether to expand Medicaid to cover adults with incomes up to $15,414 for single individuals or more for families. Utah leaders will be making that decision this fall as they prepare for the upcoming legislative session. See our new report for details.

The “Utahns for the Medicaid Expansion” (U4ME) campaign is building good momentum, gathering data and cost information and meeting regularly to puzzle out strategy.  A coalition of approximately 60-70 organizations has come together to build the case, staying on the “down low” until after November. To learn more send email to Matt Slonaker, UHPP’s new Medicaid Policy and Collaborations Director: matt@healthpolicyproject.org.

What we think

With the Feds covering 90-100% of the total cost, the Medicaid expansion is a no brainer for Utah. Still, it will be heavy lift, and after all the variables are accounted for, there will be some cost to the state. Right now legislative leaders are saying “if you testify for the Medicaid expansion, please tell us where to find the money in the state budget.” We say this is not about “robbing Peter to pay Paul.” Policymakers have a fundamental choice to make: they can pay up front only 0-10% of the total cost for cost-effective care in primary care settings, or they can pay later for care—too little, too late—in emergency rooms.

What you can do

• Prepare to testify at the Social Services Appropriations Sub-Committee Public Hearing October 4^th 11:00 AM to 12:00 PM.  When committee chairs ask you to find the money in the state budget, you can say: “We elected you and your colleagues to craft a budget that will allow the state to make and sustain worthy investments—like the Medicaid expansion. There are options for doing this—I am here to help.”

Please gather stories of individuals who will be helped by the Medicaid expansion or who have been well served by Medicaid in the past and have moved on to private insurance. Use this outreach flyer to find good stories.

A record 377,700 Utahns do not have health insurance according to the latest report released by the Utah Department of Health (see the Salt Lake Tribune article about the report here). That’s 13.4 percent of Utah’s population. Fifty-six percent of Utah’s uninsured adults are employed—and almost all of them stand to benefit from the implementation of federal health reform.  Most live in low-income households.

• 95% of the uninsured in Utah are in households with incomes less than 400% FPL, meaning if they buy private health insurance in the new individual health insurance exchange they will qualify for premium tax credits.
• 76% are in households with incomes less than 200% of poverty, meaning they would potentially be eligible for the Basic Health Plan if Utah chooses to adopt it, or if they are children, they are eligible for the Children’s Health Insurance Program (CHIP).
• 57% are in households with incomes below 133% of poverty meaning they will potentially be eligible for Medicaid if Utah expands the program to 138% FPL (see our article in this month’s newsletter).

By these numbers, most Utahns who will be using the new health exchange will have no or little experience with health insurance.  What they need are “Navigators”

Navigators are an integral part of expanding coverage through the ACA. Navigators will be trained, unbiased helpers who will do outreach to those who are eligible for coverage, assist them through the process of choosing plans, and provide guidance for prudent use of benefits.

Utah legislators face some policy decisions in the design of the Navigator program:

• formalizing the standards that all entities must meet in order to be eligible to be awarded Navigator funds through the new exchange
• creating the set of training standards all entities awarded Navigator funds must meet
• deciding if Navigators have to meet any licensing, certification, or other standards
• deciding how entities will be awarded Navigator funds
• deciding how Navigators funds will be generated (for example, a service charge through the exchange).

What we think:

UHPP encourages Utah’s decision makers to design Utah’s Navigator program with the population that will be using Navigator services in mind: 76% of Utah’s uninsured will benefit from public health insurance.

UHPP also encourages Utah’s decision makers to adopt the “no wrong door” approach to coverage—that is, where ever someone interacts with the health care system, they should be able to find help in getting coverage. One way to implement this approach is to create a competitive process for awarding the Navigator contracts, allowing multiple entities (within the guidelines) to function as Navigators in Utah.

What you can do:

The Insurance Marketplace Workgroup (a workgroup of the Health System Reform Task Force) will be discussing Navigators on Tuesday, September 11 at 10:15 AM in room 415 in the Capitol building.  Come and join the conversation.

Take Care Utah is happy to announce our next Tool Kit Training to explain how to help people enroll in Medicaid/CHIP, share customizable tools, and introduce our new website. This training will cover the same content as the last one. It will be held on Tuesday, September 18^th from 3:00 to 4:00 at the United Way (257 East 200 South, Suite 300.) Feel free to invite anyone who might be interested. RSVP to Randal@healthpolicyproject.org.

Take Care Utah is strengthening its relationship with the Department of Workforce Services (DWS). TCU will be having quarterly meetings with Dale Ownby and Steve Leyba to work together and support each other with enrollment efforts. TCU is excited about this budding relationship and is confident it will help us all maximize enrollment in our community.

Take Care Utah is happy to announce that our website is LIVE and fully loaded with tools and information to help partner agencies provide effective enrollment and navigation assistance, including our Tool Kits for community-based organizations and schools. You can access the Take Care Utah webpage here: www.healthpolicyproject.org/TakeCareUtah (capitalization needed). For any questions or feedback, please let us know through the contact us tab, or call us at 801.433.2299.

El sitio web de Take Care Utah ya esta listo!

Take Care Utah está feliz de anunciar que su sitio web ya está disponible y lleno de herramientas e información para ayudar a nuestras agencias asociadas proveer ayuda en el proceso de la inscripción y navegación efectivamente, incluyendo nuestro Kit de Herramientas (Tool Kit) para organizaciones basadas en la comunidad, organizaciones basadas en la escuela y escuelas de por sí. Usted puede acceder a la pagina web de Take Care Utah aquí: www.healthpolicyproject.org/TakeCareUtah (Las letras mayusculas son necesarias). Si tiene alguna pregunta o sugerencia, porfavor háganos saber por medio del link de “contáctenos” en la página web, o llámenos al 801.433.2299.

Take Care Utah would like to thank everyone that came to the Tool Kit Training we had on the 31^st of July.  We are truly inspired by the number of people and organizations that want to help enroll families in affordable health insurance. There were over 50 people in attendance!  Take Care Utah looks forward to working with community partners to help build our collective capacity for consumer health and navigation assistance.  If you missed the training, don’t worry: You can find most of the materials here on Take Care Utah’s new website: http://www.healthpolicyproject.org/TakeCareUtah/ToolsforPartners.html

Keep an eye out for future training sessions, including:

• Personal health information protocols + tools for protecting clients’ personal info.
• Intro and certification on the use of a well-tested enrollment assistance database, made possible through an exciting partnership with the Association for Utah Community Health.
• Overview of the Affordable Care Act and what it will mean for your clients.

Please contact randal@healthpolicyproject.org with any comments or questions you may have for Take Care Utah as we fully launch the program.  Together, we can move the needle and significantly reduce the uninsured rate in Utah.

Now that the Supreme Court has ruled that the ACA is constitutional, what does Utah need to do… and when?  The Health System Reform Task Force* held a special meeting Tuesday, July 10 to hear a report from Cathy Dupont, legislative analyst, about Utah’s options.

Utah’s two big tasks are to decide whether or not to:

1) establish an ACA compliant exchange (or let the federal government do it)
2) expand Medicaid (read about this above)

What is this really about?  Coverage.  Health insurance is the “door” that most people in the United States walk through to get health and medical care.  But 21.5% of Utah’s adults—that’s over 368,000 people—don’t have health insurance (read the Department of Health report).  Because insurance is usually attached to a full-time job, people who are out of work, self-employed, or work part-time often do not have insurance.  Ethnic minorities, young adults, and people with low incomes are also less likely to have health insurance than others.  As a society we have decided to protect the young and the old, so uninsured rates are lower for children (because of Medicaid and CHIP) and for adults over 65 (because of Medicare).  (To see Utah’s data visit the Department of Health’s data website: www.ibis.health.utah.gov.)

People who don’t have insurance usually don’t get primary and preventive care, and they delay needed medical care.  This is more expensive for everyone… for them if they pay out of pocket, and for people who do have insurance, as the cost of care that isn’t paid for is folded into insurance premiums.

PERCENT OF ADULTS IN UTAH WITHOUT INSURANCE

Source: Utah Department of Health

http://ibis.health.utah.gov/indicator/view/HlthIns.AgeSex.html

Why don’t people have insurance?  Bottom line: it costs too much. The average monthly premium in Utah’s individual market is $173, according to the Kaiser Family Foundation.  That price will get you a high deductible policy.  That’s almost 20% of an individual’s income at the federal poverty level ($931/mo) and over 9% of an individual’s income at 200% of the federal poverty level ($1,862/mo).  The ACA defines insurance as “not affordable” when the out-of-pocket cost of the insurance premium is more than 2% of income for people at 100% of the federal poverty level.  This affordability standard increases with income, to a ceiling of 9.5% income.

What we think:

Implementing the Affordable Care Act will go a long way in getting the people in Utah covered.  We need the American Health Benefits Exchange—an internet marketplace where people will be able to buy health insurance and get help paying the premiums based on their income.  We need the ACA’s navigators: community based organizations, like Take Care Utah, that will reach out and help people enroll in the right coverage for them.  We need the Essential Benefit Package: a minimum benefit package that ensures that when people buy insurance they are getting quality coverage.  In short: Utah needs the ACA.

What can you do?

Attend Task Force meetings and join one of the workgroups so that you can be part of the process.  The next meeting is at 9:00AM, Wednesday, July 18, 2012 in room 30 in the House Building at the State Capitol Complex.

Tell us your story.  Are you without health insurance?  Is it too expensive?  Have you been denied because of pre-existing condition?  Share your story with us.  Call 801-433-2299 or email Shelly at shelly@healthpolicyproject.org

*You can listen to the recording of the Health System Reform Task Force meeting and see the related materials on the legislature’s website. Go to www.le.utah.gov.  Click on audio for the July 10 (in the “archived” list) to listen.  To get materials, click on the agenda for the Health System Reform Task Force dated July 10.  Click on the desired document in the agenda to access the materials presented at the meeting.

Many of Utah’s children qualify for Medicaid or CHIP but are not enrolled.  You can help us get children covered in your area by helping your community get involved.

How?  Come to the Take Care Utah “Toolkit” training on Tuesday, July 31^st.  This training is for those interested in:

• helping people enroll in Medicaid and CHIP
• doing outreach and education
• helping people use their benefits

The training will also address how to use enrollment experience to help with health care reform.

If your organization would like to be a part of this event, contact randal@healthpolicyproject.org.