New Options for Immigrants Under the Affordable C are A ct of 2010 ACA individuals who are lawfully present in the United States are now eligible for new affordable coverage options that started January 1 2014 ID: 329092
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Slide1
Individuals Within Mixed-Status Families Eligible Under the Affordable Care ActSlide2
New Options for Immigrants
Under the Affordable
C
are
A
ct of 2010 (ACA) individuals who are “lawfully present” in the United States are now eligible for new affordable coverage options that started January 1, 2014.
US citizens
“Lawfully Present”Slide3
Immigrant Statuses that Qualify for Marketplace Coverage
•Lawful Permanent Resident (LPR/Green Card holder)
•
Asylee
•Refugee
•Cuban/Haitian Entrant
•Paroled into the U.S.
•Conditional Entrant
•Battered Spouse, Child and Parent
•Trafficking Survivor and his/her Spouse, Child, Sibling or Parent
•Granted Withholding of Deportation or Withholding of Removal, under the immigration laws or under the Convention Against Torture (CAT)
•Temporary Protected Status (TPS)
•Lawful Temporary Resident Slide4
•
Individual with Nonimmigrant Status (includes worker visas, student visas, and citizens of Micronesia, the Marshall Islands, and Palau)
•Administrative order staying removal issued by the Department of Homeland Security
•Member of a federally-recognized Indian tribe or American Indian born in Canada
•Deferred Enforced Departure (DED)
•Deferred Action Status* *EXCEPTION: Individuals granted deferred action under the Deferred Action for Childhood Arrivals (DACA) program are not eligible to enroll in coverage in the Marketplace.
Cont. Slide5
Mixed-Status Families
What is a mixed-status family?
Mixed-status family refers to a household made up of individuals with different citizenship or immigration statuses, such as a family with an undocumented mom, a “lawfully present” dad, a child who is a US citizen because he or she was born in the United States. Slide6
Quick Guide to Immigrant Eligibility for ACASlide7
Who is eligible for coverage in a mixed-status family?
Each member of a mixed-status family may be eligible for a different health insurance program and some members may not be eligible for any health insurance program.
Eligibility for private health insurance and the subsidies that make insurance more affordable also know as premium tax credits and cost sharing reductions through the ACA’s health insurance marketplace are only available to US citizens and people who are “lawfully present” in the US. Slide8
Undocumented Immigrants
No federal coverage
Not allowed to purchase private health insurance at full cost in a state insurance exchange
Not eligible for premium tax credits or lower copayments
Exempt from the individual mandate
Citizen or lawfully present children of undocumented parents are eligible:
To purchase from state insurance exchange
For premium tax credits and lower copayments
Medicaid or Children's Health Insurance Program (CHIP)Slide9
Undocumented
Immigrants cont.
Undocumented Immigrants who do not meet the Medicaid immigration eligibility requirement or are not eligible to purchase through the marketplace can still apply for :
Emergency Medicaid
Immunizations
Community Health Centers/FQHCs
Migrant Centers
OthersSlide10
Can an eligible member of a mixed family apply for Medicaid or a marketplace plan?
YES!
A person who is not eligible, such as an undocumented parent, may apply on behalf of eligible family members, including when the ineligible person is the head of household and the household’s primary tax return filer.
Immigrants in general, and mixed status families in particular, often do no know what they may be eligible for and are worried about applying. They need reassurance from eligibility workers and other experts from whom they seek help. Slide11
Non applicant
A non applicant is someone who is not applying for health insurance but who is in an applicants household. By law, the information required from a non applicant is limited because only information strictly necessary to determine an applicants eligibility may be required.
Should not be asked for their citizenship or immigration status
May say “I’m not applying for myself. I’m only applying for my child.”
Must provide information about their income
Will be asked for SSN, but do not have to provide one if they do not have one. Slide12
Key Points to remember about mixed-status families
An ineligible family member such as an undocumented parent may complete an application for an eligible member such as a US citizen child.
By law, individuals who are not applying for themselves are not required to provide information about their citizenship or immigration status and are not required to provide a Social Security number if one is not issued to them.
Information about applicants or members of their households obtained in order to determine eligibility will not be used by US Immigration and Customs Enforcement (ICE) for immigration purposes. ICE issued a clarification of this policy on 10/25/13
http://www.ice.gov/doclib/ero-outreach/pdf/ice-aca-memo.pdfSlide13
Do mixed-status families have to file tax returns because of the ACA?
If a member of a mixed-status household is eligible for a premium tax credit to make health insurance more affordable under the ACA and enrolls in a health insurance, the household must file tax returns for the year in which they eligible person has health insurance.
A tax return must be filed in order to “reconcile” the amount of the tax credit and so the applicant can be eligible for a premium tax credit when he or she renews his or her coverage for the following year. If the household’s primary tax filer is not eligible for a SSN, the household must file tax returns using an ITIN. Slide14
Example:
Mom, who is undocumented, applies for health insurance for her US citizen son. The marketplace determines that they boy is eligible for a premium tax credit and he is enrolled in health insurance for 2014. Since they boy is eligible for a premium tax credit, mom must use an ITIN to file an income tax return for the 2014 tax year by April 15, 2015, tax filing deadlineSlide15
Individual Mandate - Penalty
2014
1% of your yearly household income
$95 per person for the year ($47.50 per child under 18)
2015
2% of your yearly household income
$325 per person
2016
2.5% of your yearly household income
$695 per personSlide16
Public Charge
Public Charge is a term used in immigration law that describes a person who cannot support themselves and who depends on benefits that provide cash for their income.
Depending on your immigration status, the Department of Homeland Security can refuse to let you enter the US, reenter the US, or become a lawful permanent resident if they think you will not be able to support yourself without these benefits in the future. Slide17
Highlights of Public Charge
Use
of Medicaid, CHIP, or other health programs by you or your family members will NOT affect the public charge decision.
Use of food stamps, WIC, public housing or other noncash programs by you or your family will NOT affect the public charge decision
Buying health insurance through the new health insurance marketplace and obtaining premium tax credits or cost sharing reductions that make coverage more affordable will not be considered in the public charge decision. Slide18
Important dates and Resources
Open Enrollment for 2015
November 15, 2014 – February 15, 2015
Arizona Alliance for Community Health Centers – www.aachc.org
National Immigration Law Center – www.nilc.org
Health Insurance Marketplace - www.healthcare.gov
AZ Medicaid, Nutrition Assistance + more - www.healthearizona.org
Cover Arizona – www.coveraz.orgSlide19
Thank You!
David Aguirre, Arizona Alliance of Community Health CentersSlide20
Assisting Special Populations: People with DisabilitiesSlide21
How do Disability Rights Laws Affect the Operation of the Marketplace?
The 1990 Americans with Disabilities Act and the 2010 ADA Amendments Act along with Section 504 of the 1973 Rehabilitation Act prohibit discrimination against people with disabilities.
These laws apply to the programs delivered through the Marketplace
,
the federally conducted Marketplace infrastructure
, and
to the organizations that will assist consumers to learn about their healthcare insurance options. Slide22
How do Disability Rights Laws Affect the Operation of the Marketplace? Cont…
Consumer education materials, websites, or other tools utilized for consumer assistance purposes must be accessible to people with disabilities including those with sensory impairments, such as visual or hearing impairments, and those with mental illness, addiction, and physical, intellectual, and developmental disabilitiesSlide23
What do Navigators Need to Know about Disability?
As a CAC or NAV, your role is to help consumers obtain health insurance
coverage, and you might also need to assist some people with
Disabilities identify additional healthcare programs or services for which
they might be eligible.
Some local disability and affinity organizations are excellent resources
That can assist or advise about programs such as
Supplemental Security
Income SSI)
,
Social Security Disability Insurance SSDI)
,
Medicare
,
Pharmaceutical assistance programs
,
and
Medicaid home and
community-based services (HCBS)
.Slide24
Plan Ahead
It is best to build relationships with support groups in advance. Make contact with organizations when you are in the early stages of planning for an outreach event or developing written materials, so when the need arises you will have ready access to referral services. Slide25
What is disability Etiquette?
While some disabilities are visible, others are hidden.
People with functional impairments may not see themselves as someone with a disability.
Always be respectful and avoid referring to someone by his/her disability.
Use “
people first” language – person with a disability. Be willing to spend extra time, if necessary.Slide26
Consumers with Disabilities: Who Are They?
Workers with Disabilities
Includes some previously excluded from individual or small business insurance due to preexisting condition discrimination or lifetime limits
Individuals on SSDI in the two year Medicare Waiting Period.
Families with dependents under age 26 with
disabilitiesSlide27
Visual Impairment
People with visual impairments or who are blind might
require print materials in accessible formats such as
Braille
,
audio, digital, or large print formats. Or people who are deaf or hard of hearing might
require
Sign Language interpreters
in order to ensure
effective communication. Slide28
How can local disability and affinity
org’s
help you?
For example
, local disability and affinity organizations
can help you learn how to arrange and pay forappropriate accommodations that some peoplemight need to understand their health insurance options. Slide29
Hearing Impairment
Who can help me if my organization needs to hire a Sign Language interpreter or a transcription service?
Many local groups are good resources on specific topics and issues. For example, deaf service organizations, such as associations of the deaf, can help identify qualified Sign Language interpreters for hire and other communications services such as Communications Access Real time Translation (CART), the instant translation of the spoken word into English text.Slide30
What types of organizations should I know about?
Disability organizations can be local, regional or national in scope and vary in mission and purpose from locale to locale.
Here are some examples of:
national organizations that have chapters or affiliates in many locations,
local organizations that belong to a national membership group:Slide31
Disability Organizations
Centers for Independent Living
are community-based, cross-disability, non-profit organizations that are designed and operated by people with disabilities.
All Centers for Independent Living provide the same core services: peer support, information and referral, and individual and systems advocacy. Centers generally also have expertise in helping people with disabilities apply for federal programs such as
SSI and SSDI
, and home and community-based services.
Slide32
Who to contact in my area
Arizona Bridge to Independent Living (ABIL)
5025 East Washington
Phoenix, AZ 85034
www.abil.org
Phone Numbers:Local: (602) 296-0513
Accessible: (602) 296-0591
Accessible Phone Type: TTY
Counties Served:
Maricopa and parts of Pinal, Gila, Mojave
New Horizons ILC
8085 East Manley
Prescott Valley, AZ 86314
http://www.newhorizonsilc.org/
Phone Numbers:
Local: (928) 772-1266
Toll-free: (800) 406-2377
Accessible: (928) 772-1266
Accessible Phone Type: TTY
Counties Served:
Mohave, Yavapai, Coconino, Navajo, Apache
SMILE Independent Living Center
1935 South Arizona Avenue Suite 4
Yuma, AZ 85364
http://www.smile-az.org
Phone Numbers:
Local: (928) 329-6681
Toll-free: (866) 239-7645
Accessible: (928) 782-7458
Accessible Phone Type: TTY
Counties Served:
Yuma, La Paz
DIRECT Center for Independence, Inc.
1023 North Tyndall Avenue
Tucson, AZ 85719
http://directilc.org/
Phone Numbers:
Local: (520) 624-6452
Toll-free: (800) 342-1853
Accessible: (520) 624-6452
Accessible Phone Type: TTY
Counties Served:
Pima, Graham, Greenlee, Santa Cruz, CochiseSlide33
Support for specific disabilities
The Arc
is the largest national community-base advocating for and serving people with intellectual and developmental disabilities and their families.
The National Alliance on Mental Illness (NAMI)
is the nation’s largest grassroots mental health organization with 1000 affiliates across the country.
The National Multiple Sclerosis Society (NMSS) conducts research and advocacy, and operates programs and services for people living with MS.
United Spinal Association’s
works to improve the quality of life of all people living with a spinal cord injury or disease. United Spinal provides active-lifestyle information, peer support and advocacy, which empower individuals to achieve their highest potential in all facets of life.
The Lighthouse
provides resources and information for people with vision loss.
The American Council of the Blind
shapes policies that affect people who are blind.
The National Association of the Deaf (NAD)
is a leading civil rights organization for people who are deaf and hard of hearing. Slide34
Resource Page
http://www.ilru.org/projects/cil-net/cil-center-and-association-directory
http://www.adrc-tae.acl.gov/tiki-index.php?page=HomePage
http://www.thearc.org/Page.aspx?&pid=292
http://www.nationalmssociety.org/Chapters
http://www.spinalcord.org/nscia-support-groups/location/arizona/
http://www.lighthouse.org/resources/help-near-you/
http://acb.org/node/72
http://hab.hrsa.gov/gethelp/index.html
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-SupportS/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html
Register & Create an accountSlide35
Thank You!
Marco Mendoza
Program Manager – Keogh Health Connection
mmendoza@keoghhealth.org