Got Healthcare? The Affordable Care Act


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The easy-to-understand explanation of what the Affordable Care Act, the national health reform law, means for Wisconsin consumers!

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Got Healthcare? The Affordable Care Act

  1. 1. The Affordable Care ActMaking health care more secure and returning control to consumers 1
  2. 2. STOP!!Are you watching this online instead of in person? If so, youare missing out some of the most impressive facts, the bestmessages for talking about the law and the opportunity to get your questions answered in real time! Invite Citizen Action to speak at your next meeting, we speak at…•Congregations •Support Groups •Nonprofits •Classrooms•Businesses •Political meetings •Union Meetings •Senior Centers•Civic Groups •Professional Associations •House Parties •And more! Anywhere in Wisconsin, completely free! Kevin Kane, Healthcare Organizer Back to the 414 550 8280 Presentation…
  3. 3. Our Health Care Principles What guides the work we do:• Health Care Freedom must be restored. Medical decisions should be controlled by patients in consultation with their healthcare providers, without interference from insurance companies• Everyone should have health security, – the ability to purchase quality coverage at a fair and affordable price.• Health Care discrimination by insurance companies is a violation of fundamental rights, especially against people with preexisting conditions, and must be outlawed. 3
  4. 4. The Affordable Care ActThe new national health care law, achieves these principles --Passed March 23, 2010 --Reforms Come in 2 Stages Happy 2nd Birthday ACA! 4
  5. 5. Stages of Reform Stage 1 (in effect now) • Outlaws worst health insurance abuses including denials based on preexisting conditions for children (adults with preexisting conditions will be covered in 2014). • Creates new standards for insurance, such as allowing young2.5 million youngadults now have adults to stay on parents policiescoverage thatdidn’t before! until they are 26. 5
  6. 6. Stages of ReformStage 2 (goes into effect 2014)• Expand BadgerCare (Medicaid) to almost all low income Wisconsinites.• Create competitive health marketplace to guarantee coverage to everyone who does not have good insurance at work.• Require Members of Congress to buy the same plans offered to everyone else in the new marketplace.• Strengthen Medicare for Seniors. 6
  7. 7. Stage 1 Reforms Insurance Practices Outlawed now under the Affordable Care Act • Preexisting condition exclusions (kids now/ everyone in 2014) • Lifetime limits • Dropping coverage after a person gets sickThe Governortried to block• Excessive insurance industry profits andthis for 3 overhead (80-85% of your premium dollarsyears, butwas prevented must be spent on medical care, not profits)from doing so 7
  8. 8. Stage 1 Reforms The Affordable Care Act guarantees • Preventive care coverage (ex: Mammograms, checkups, etc) with no costGet care sooner sharing (co-pays, deductibles, etc)It savesMoney & lives!• Young adults can stay on parents policies until age 26 • Preventive care without cost sharing for seniors on Medicare Seniors have enjoyed this all of last year 8
  9. 9. The Affordable Care Act Ends Discrimination for 2.5 Million Wisconsinites Under 65• Nearly 1 Million in Wisconsin under age 65 have a preexisting conditions that would deny coverage to them if they bought insurance on their own• An additional 1.5 million non-elderly Wisconsinites have preexisting conditions that could cause them to be denied coverage or charged excessive rates.(Source: U.S. Department of Health & Human Services, January 2011) 9
  10. 10. Just Some of the Examples of Preexisting Conditions 10
  11. 11. The Faces of ReformHow the Affordable Care Act is already helping people across Wisconsin who would otherwise be the victims of health insurance discrimination 11
  12. 12. Sami’s Story “My 7-year-old son, Sami, suffers from a disease that causes tumors to grow all over his body. Sami’s treatments could not continue if we hit our insurance policy’s life time limit. Thanks to the Affordable Care Act, insurance companies can no longer impose lifetime limits or deny health coverage to children like Sami with preexisting conditions. We can’t go back to being on our own against the insurance companies.” --Tracy, Appleton, Wisconsin. Without the Affordable Care Act’s protections, 12 What would this family do?
  13. 13. Remy’s Story“I own a small café. Over 20 years ago I beat cancer, but ever since then no insurance company would sell me a policy because my cancer is called a preexisting condition. Starting in 2014 under the Affordable Care Act, no insurance company will be allowed to discriminate against me because I’m a cancer survivor.” --Remy, Pepin, Wisconsin 13
  14. 14. Stage 2: Guaranteed Affordable Health Care (2014) • Wisconsin, with federal funding, The Governor creates a new competitive health blocked $38million to create marketplace, while keeping whatthis. We will still have one, but works now in place. the Federal •Government will The new health marketplace optionsnow create onefor us instead of are voluntary. If you have good the state. coverage through your job you can keep it. 14
  15. 15. Competitive Health Marketplace for Middle Class• Created by each state to meet unique needs by 2014.• Access through website, similar to Travelocity or Consumer Reports, chose your own private insurance carrier and standards benefits plan.• System voluntary: can stay with current health insurance if it works for you.• Consumers in control, with clear information, clear comparisons, and real competition. 15
  16. 16. Competitive Health Marketplace• Makes coverage more secure by ensuring that people cannot be denied coverage due to preexisting conditions or have coverage dropped when they get sick.• Members of Congress will be required to get their coverage through the same competitive marketplace• Makes coverage more affordable, by providing tax credits on a sliding scale to middle class Wisconsinites.• Offers new options, such as a new nonprofit insurance cooperative company• Bans discriminatory pricing based on 16 medical condition, age, or gender.
  17. 17. Gender Discrimination• In one of the most glaring inequities, women are charged more then men by health insurers.• This and other kinds of discrimination are outlawed in the new competitive health marketplace. 17
  18. 18. Stabilizes & Expands BadgerCare to low income Wisconsinites • BadgerCare expanded to include every citizen who meets income requirements • Wisconsin’s contribution of BadgerCare expansion is substantially reduced. • Eliminates the risk of BadgerCare cuts.What is happeningnow in Madison re: • Affects 337,000 Wisconsinites Badger-kicking tens ofthousands off of Care (Medicaid) recipients with seriousBadgercare will notbe allowed in 2014 and chronic diseases such as Cancer, Lung Disease, Diabetes & Heart Disease. Conditions, that if denials due to preexisting conditions didn’t occur 18 (and in 2014 they won’t), will be able to get health coverage
  19. 19. Strengthen Medicare The Affordable Care Act protects Medicare benefits for seniors and strengthens the program for future generations bySaved $4 • cracking down on waste, fraud, andBillion last abuse in Medicare,year alone! • ending handouts to insurance companies, and • providing free preventive care to decrease costly emergency room visits 19 and reduce health care costs long-term.
  20. 20. Faces of ReformThe human impact of the new competitive health marketplace . . . . 20
  21. 21. John’s Story"I have a tooth that is in infected and needs to be removed, which normally costs $100, but because I have Hemophilia the drugs are between $50,000 & $100,000 just to stop the bleeding. I have been denied insurance because of my condition, any employer-based care would require me to wait a year. I have no way of dealing with my conditions the way things are now. That is why I am looking forward to the new health marketplace."  --John, Small Business Owner, Albany, WI 21
  22. 22. Steve’s Story"I suffered from a deteriorating spine problem for about 10 years...We discovered what so many Americans have had the misfortune of discovering-It was impossible to purchase health insurance on the free market if you were considered high risk (had a pre-existing condition)...We applied many times over the years to every health insurance company we could find and were flat out rejected… with little other option I took a 20 hour flight to Malaysia to get treatment. Under the Affordable Care Act, I will have a right to coverage so I can get treatment here in the U.S.” --Steve, Verona, Wisconsin 22
  23. 23. The Choice• There will be change: because of skyrocketing health costs everyone agrees we need to change.• One option is to continue implementing the Affordable Care Act, which is already protecting us from health discrimination and will guarantee greater security and control.• The second option on the table is the “Pathway” Budget plan which passed the U.S. House of Representatives in 2011 & introduced again in 2012 23
  24. 24. Pathway Plan1. Repeals the Affordable Care Act, allowing insurance companies to deny coverage to millions of people with preexisting conditions and drop coverage for those who get sick, forcing many into bankruptcy.2. Ends Medicare as we know it, and gives seniors vouchers that will not keep up with medical inflation, doubling their out- of-pocket costs. 24
  25. 25. Pathway Plan• Cuts $810 billion from Medicaid, including funding for long term care for seniors and people with disabilities, and BadgerCare for children & families.• Gives $10 trillion in taxpayer funded subsidies to the health insurance industry over life of the plan.• Prevents creation of competitive health marketplace where everyone who needs it will have a choice of good plans and tax credits to afford them. 25
  26. 26. The Affordable Care Act is Worth Protecting• Guarantees health care freedom. Working families no longer can be denied coverage for preexisting conditions, lose their coverage when they get sick, or have to haggle with insurance companies about claims and crucial medical treatments.• Everyone will have the peace of mind of knowing that they and their families have guaranteed access to affordable coverage options, no matter what.. 26
  27. 27. Affordable Care Act is Worth Protecting • Increased opportunity: families will notGroups that struggle be forced into bankruptcy whento get coverage now:-Entrepreneurs someone gets sick, and will be free to-Small biz owners-Farmers pursue economic opportunities without-Contractors-Nonprofits being constrained by health insurance-Churches access name a few • Wisconsin should work to improve the new law by implementing it in a way that works for everyone, not special interests such as the health insurance industry. 27
  28. 28. How You Can Help• Real Stories change hearts & minds, share your health care stories with us!• Hold a house party and invite us to learn how to “Talk Health Reform”, or invite our speaker’s bureau to your next event!• We need speakers to present this presentation to others• Does your small business need better insurance? Let us know! 28
  29. 29. Questions?• Kevin Kane Healthcare Organizer Citizen Action of Wisconsin 414 550 8280 (cell) 29