Affordable Care Act

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Affordable Care Act

• New ChoicesMore Coverage

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Major changes

• Compared to the current healthcare system in
  America, the Affordable Care Act provides
• Expanded Access.
• Ends Abuse.
• More Affordable.
• Enhanced Quality.

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Expanded access

• Pre-Existing Condition Insurance Plan (PCIP)
• Community Care Centers
• Long-Term Care Options
• Young Adult Coverage
• Insurance Exchanges
• Consumer Operated and Oriented Plan (CO-OP)
  Insurance Plans

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Pre-existing condition insurance plan

• Insurance to individuals previously denied
  coverage due to their medical conditions.
• Covers primary and specialty care, hospital
  care and prescription drugs, even those related
  to the pre-existing condition.
• Requirements
• 1) US citizen or legal US resident.
• 2) Without insurance for at least 6 months.
• 3) Have a pre-existing condition, or denied
  coverage due to a pre-existing condition.

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Community care centers

• In low income communities, the Act allows for
  expanded access to health care by increasing the
  number of community health centers that provide
  free or more affordable care.

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Long term care options

• Creates a program Community Living
  Assistance Services and Support (CLASS)
• CLASS is an insurance plan that allows
  consumers to pay via payroll deductions while
  that individual is in the workforce.
• CLASS provides coverage beyond Medicare for
  non-medically related services like daily living
  care.
• Gives individuals more opportunities to receive
  long-term care from home, instead of in nursing
  homes or hospice.

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Young adult coverage

• Prior to the Affordable Care Act, insurance
  companies could remove children from their
  parents insurance at age 19.
• Full time students or part-time workers in
  their 20s often could not afford insurance.
• The Affordable Care Act allows them to stay on
  parents insurance until age 26.

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Exchange program

• Program designed to make buying private or
  public health coverage easier for small
  businesses and individuals.
• 1 stop shop to
• Compare health plans.
• Get answers to questions about health coverage
  options.
• Find out eligibility and which tax credits
  might apply to lower overall costs.

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Co-op plans

• Consumer Operated and Oriented Plans
• CO-OP is a new type of non-profit health
  insurance plan where insurers are run by
  customers.
• Individuals or small businesses elect board of
  directors - made up of other CO-OP customers.
• Profits must be used to lower premiums and
  improve benefits.
• Individuals or small business owners can join
  together in creating a CO-OP with government
  loans to get the CO-OP started.

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Ends abuse

• Protects against cancellation of coverage, even
  after an individual becomes sick, due to
  application errors.
• Revamped appeal process when payment or care is
  denied.

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• Protects against premium hikes.
• Protects against pre-existing condition
  discrimination.
• Protects against charging higher rates to women
  during their reproductive years.

Ends abuse
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More affordable

• 25 million of federal funding will go to
  states and communities for pregnant and
  parenting women and teens.
• More lower income households will be eligible
  for Medicaid. 14,000 for individuals and
  29,000 for families.
• Medicare recipients and the elderly will have
  access to free preventative care.
• Annual check-ups
• Cancer screening

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More affordable

• Lower middle income individuals and families
  access to tax credits to assist them in paying
  for health insurance.
• Small Businesses
• Small businesses with 50 or employees, (96
  of all businesses) no longer have to guarantee
  insurance because employees would have more
  options.
• If the small business chooses to offer
  insurance, tax credits given to offset costs.

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Enhancing Quality

• Partnerships for Patients
• Better Care Lower Costs
• A public-private partnership with the goal of
  preventing injuries and improving care outcomes.

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Enhancing Quality

• Accountable Care Organizations will be created
  to help coordinate care to lower costs and
  improve quality by closing gaps in care and
  preventing duplicative care.
• The Act has already provided more than 130
  million dollars for community medical centers
  for equipment and staffing.

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Ongoing debate

• Is the Affordable Care Act good for America?
• Is it a "socialist and "unconstitutional"
  government takeover of the health care system?
• Will it increase the cost of health care and
  decrease the quality?
• Will the law cost more than 2.5 trillion over
  10 years and drive the US deeper into debt?

?
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Websites you should know

• http//www.healthcare.gov/index.html
• Government created website which provides
  in-depth explanations of the Affordable Care Act,
  insurance options and changes.
• http//younginvincibles.org
• This site was created by young adults, for young
  adults. It encourages people from the age of 18
  to 34 to advocate for issues that affect them.
• http//www.healthcareandyou.org/what-is/
• This site was created by The Healthcare and You
  Coalition and provides easy-to-understand
  information about the new health care law.

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Whats Next?

• What did you learn?
• What do you still need to figure out?
• What will you do with the information?