Good afternoon, everyone. My name is Elizabeth Jennings and I am training and technical assistance to with the National Disability Institute and it is my pleasure to bring you to our webinar, The NEW Healthcare Changes and You. Typically we try to wait a few minutes as we have a lot more people register them have joined so far. But, we have so much to share with you today that we don't want to waste even a moment to make sure that you have enough time after our presenter today to answer any questions that you may have and to make sure that you have all of the information that you need. Before we get started, I'm going to invite my colleagues, Nakia Matthews, to offer a few housekeeping tips.

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Thank you so much. So today, we are going to provide for you an overview of the financial wellness and why did we discussed this in regards to individuals with MS. We are going to introduce Tanya Schwartz who is with us todayto provide you an overview of the health care changes and you. She will be sharing with healthcare changes mean with individuals with disabilities, when they take effect, the overall impact of the new health care legislation and she has put together several quality resources for you. We are also going to offer some time to do questions and answers with Tonya and if we don't have enough time today to answer your questions, please don't be concerned. You can send them a manual answer them after the webinar.

, To start by offering a special thank you to our sponsor, Acorda Therapeutics . For the past few years, they have provided funding to National Disability Institute to provide that MS financial wellness webinar series and we're very grateful to them for their support. For those of you who have not been with us before, National Disability Institute is a national research and investment organization with the mission to promote income preservation, the asset the government for persons with disabilities. We are a group with the sole mission to build a better economic future for Americans with disabilities.

When we talk about financial wellness, we are talking about a state of a person's finances with the intent of working toward financial behaviors that limit stress and the impact of stress on one's daily life. Financial wellness can have many components. It can be increasing our financial literacy, accessing affordable financial services, utilizing favorable tax provisions, which we will talk about next month December's webinar, financial wellness can include budgeting, understanding or public benefit rolls, to empower you to earn more or to save more, building and maintaining assets, accessing available health care subsidies, and understanding work in your long-term disability options.

If you have not had a chance to tune into other webinars in this series, I hope you will as we cover each of these components in our attempts to help you as you seek to build your own personal financial wellness.

We are very interested National Disability Institute on the interstate disability and poverty because the property for people with disabilities are twice the rate than those without. In 2011, individuals without disabilities live below the poverty level at a rate of 12.4%. And, individuals with disabilities live below the poverty level at a rate two times that, 27.8%. We know that despite the many opportunities that exist, there is no group in a manner that is in more need are more deserving of economic recovery than those living with disabilities. For millions of working age adults with disabilities, a dependence on public benefit for critically needed income, healthcare, food and or housing often becomes a trap that requires staying poor to stay eligible. And part of what we seek to do is encourage individuals to have quality and patient to fully understand their options and to make informed choices about their public benefits.

Much of our work is derived from the Americans with Disabilities Act act. This access the Phoenicians proper goals regarding individuals with disabilities are to ensure equality of opportunity, full participation, independent living and economic self-sufficiency. If that is the piece that we really focus on, the economic self-sufficiency. Our goal is that this webinar series will support each individual's rights to have equal opportunities to be economically self-sufficient. Why is that important to us and to many of you on the line? It is because I'm so wellness can have an impact on the mental and physical health. And the level of stress that our finances cause can create great havoc with our physical health. It also positively impact your self-concept, changes your status with other community members, directly affect our quality of life, and many of us who need things like -- like prescription drugs, accessible transportation, having come available to afford those things can make a critical difference in our ability to participate in community life.

Before we started this webinar series back in 2011, we completed a survey with our partners at the MS Association of America event at great deal that we used to construct the webinars each year. We learned that more than half, 55.1% of households surveyed less than $35,000 annually, and 16.4% earn less than $50,000, but more than $35,000. When asked about the ability to pay all of their bills in a typical month, 32% reported they had a very difficult time paying their bills and almost half, 46 point & reported a somewhat difficult time. Also, 43% of respondents responded that their financial status has affected their ability to access medical care at some point in time.

We further found that 71.7% of people who responded to the survey do not have enough savings to cover three months extended -- expenses. That is a key indicator that a person's financial wellness is off. 67.1% of respondents reported that their answers were worse since their MS diagnosis. And, almost 2/3, 73.7% reported that they were not aware of or have not used several financial stability programs that we talk about through this series, the earned income tax credit, individual development accounts, family self-sufficiency programs, and social security's plan for achieving selfhood court -- self-support. There are many financial wellness strategies that exist in that we talked about throughout this webinar series. Again, if you have not had a chance to learn about one or more of these opportunities, I hope you'll visit the archives which we will post the link to image box so that you can have them available to you.

We talk about many of them and we have other supports and services to offer if you're invested in more information. But, the strategies can put all of the different components that have endorsed -- on your screen. Today we want to focus on access to healthcare and how your healthcare can impact your opportunity to improve your financial wellness. So, I am thrilled to present to you today Tanya Schwartz, a manager at Manatt Health Solutions. She is an interdisciplinary policy and business advisory -- I am sorry, she is manager with Manatt Health Solutions and interdisciplinary policy and business advisory division of [ Indiscernible ]. She provides strategic business and regulatory advisement policy analysis and project oversight to profit in private homes and issues relating to federal health care reform, public health insurance programs, including Medicare, Medicaid and the children's health insurance program, or CHIP.

Prior to joining Manatt Health Solutions, she served in various roles at the centers for Medicare and Medicaid services and worked as a policy advisor to the Director. of Medicaid and CHIP, technical director for initiative to provide support and assistance to states on Medicaid changes under the affordable care act and the revelations that codified many Medicaid and CHIP provisions. Prior to working at CMS, she was a policy analyst with the Kaiser commission on Medicaid and the uninsured at the Henry J Kaiser family foundation. You can learn more about her at the link provided, and I am just so grateful to her for participating with us today and offer a warm up to Tanya Schwartz. Thank you for joining us. Thank you so much, Elizabeth, and good afternoon, everyone. I'm happy to be here and thank you for asking me to participate today. I'm sure that many of you have been hearing lots of news reports about the implementation of the affordable care act which has also been referred to by many other names. So today, we are going to talk about the health coverage options that may be available to you, to your family members, to your friends. And so, this conversation today will give you a broad understanding of the health coverage options that are available and how they work. But, it will be quite a bit of information is at the end, going to take it back and think about the practical information that people need to know when they apply for coverage because while it is helpful to understand how all of these rules and eligibility around all of these options, in the end, if you do apply for coverage, you will provide some information about you and your family and the system will decide which program you are eligible for. And so, at that point, we want to make sure that you know what questions you want to ask at that point when you know what program you're eligible for tuning sure that you're getting a health plan covers your needs as best as possible. Both tuning sure it covers the benefits you need, and to make sure that there are financial projections that you can afford coverage.

So again, we will take a step back at the end and themepark tickly about steps that you can take to apply for coverage and what to do after you obtain coverage.

So, let's dive right in. Today, I am going to do just a broad overview of the Affordable Care Act and some of the coverage changes and give a landscape of some of the broad provisions. We're then going to talk about some key private insurance market reforms that really get at new rules to prevent insurance companies from discriminating against individuals and to guarantee coverage for all Americans.

We then going to talk about the new Medicaid expansion, which expands Medicaid insert states, some states have decided not to expand Medicaid at this time so we'll get into that. After we talk about Medicaid expansion, with all parts were some questions and then we'll move into the new market basis. Which I am sure you have heard a little bit about with all of the news around it. But, we will talk about the marketplaces and who is eligible for the marketplaces and financial assistance that people can get in the marketplaces. We will then take another pause for questions there just to try to break it up a little bit, and then as I mentioned before, we will end talking about some practical information that is helpful for consumers when applying for coverage in selecting their plans.

So, the Affordable Care Act, has ever referred to it today was signed into law in March of 2010 and it makes major changes to help uninsured people and underinsured people secure coverage in the United States.

As we have done in today's presentation, I have three buckets of coverage changes. We have new market insurance reforms, we have the expansion of Medicaid insert states, have the establishment of new marketplaces where individuals and small businesses can purchase private health insurance, then we also have what we call new insurance affordability programs which provide financial assistance insurance. People can apply for all of these different types of coverage using one single application and we'll talk about that a little bit later. So, when you apply, you don't need to know what you're applying for, you can imply them to figure out what you are eligible for. So, the Affordable Care Act does make a member of other changes to the healthcare delivery system, establishes some new public health should, and includes a range of other provisions. So, we are not to talk about those today. We are not going to get into Medicare long-term care services because there's just so much to cover on this topic alone so we will touch on those today. If people have questions on them they consent to be happy to try case is almost be able to fit everything in today because there's so much to talk about.

This slide explains how all of these different programs fit together. So, we have Medicaid at the top four states are expanding Medicaid bill up to about 138% of the poverty level which is a little bit over 15,000 for individual and a little bit over $31,000 a year for a family of four that is states expand Medicaid. We then have the children's health insurance program, which is for children, this eligibility level varies by state. We then have these new qualified health plans, which are the other things that you can purchase in the marketplaces. And, qualified health is our available to people at all income levels, but people up to 4% of the poverty level which is about $46,000 in income a year or about $94,000 annual income for a family of four, those people may be eligible to get financial assistance paying for this coverage in people over that, Matt can purchase qualified health plans at low cost. Of course, we still have employer-sponsored coverage in most Americans today, about two thirds, get their coverage through the employers. This shows how all different coverage programs fit together.

Is estimated that millions of people are going to be able to get health coverage through these new 15 coverage expansions. So you can see here that the number of uninsured is expected to be reduced from about 55 to 31, so a reduction in short of 24 million people. We expect to see a little bit of preset Medicaid because of this Medicaid expansion, about 11 million more people are expected to get Medicaid coverage. Then, the Congressional Budget Office projects that about 25 million people will and rolling these new marketplaces. Many of them will get financial assistance helping to pay for coverage. Then you can see there's also a slight increase in America people expected to get employer-based coverage.

We are going to dig into these private insurance market reforms. Under the Affordable Care Act. In these insurance market reforms apply to all health insurance plans. Not just went in Medicaid or the marketplaces but all plans. There really important reforms that help millions of Americans, especially people with pre-existing health conditions. So on the first bullet, insurance companies can no longer deny coverage to an individual because of pre-existing condition including disability. They also cannot drop people from their coverage or refuse to renew their coverage because of pre-existing health conditions. So this is very, very important for so many of us who have pre-existing health conditions. So that is a huge, huge reform that was included in the Affordable Care Act. Insurance companies cannot charge more because of a person's health status or their gender, which is also very important. So the plan things can only vary by a few factors that are listed here. We know that costs vary based on where you live, there are some variations that is allowed by each, if you are a smoker, there may be some additional cost that apply to you looking sites which is basically a coverage for yourself or also you're tired. Desk or your entire family.