AFFORDABLE CAREACT▲ New Choices…More CoverageHOSA - Future Health Professionals6021 Morriss Road, Suite 111Flower Mound, TX 75028800-321-HOSAwww.hosa.orgUsed with permission from National HOSA
MAJORCHANGESCompared to the currenthealthcare system in America, theAffordable Care Act provides:• Expanded Access.• Ends Abuse.• More Affordable.• Enhanced Quality.
EXPANDEDACCESS• Pre-Existing Condition InsurancePlan (PCIP)• Community Care Centers• Long-Term Care Options• Young Adult Coverage• Insurance Exchanges• Consumer Operated and OrientedPlan (CO-OP) Insurance Plans
PRE-EXISTINGCONDITIONINSURANCEPLAN• Insurance to individuals previously deniedcoverage due to their medical conditions.• Covers primary and specialty care,hospital care and prescription drugs, eventhose 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 deniedcoverage due to a pre-existing condition.
COMMUNITYCARECENTERS In low incomecommunities, the Actallows for expandedaccess to health careby increasing thenumber of communityhealth centers thatprovide free or moreaffordable care.
LONGTERMCAREOPTIONS• Creates a program Community LivingAssistance Services and Support (CLASS) CLASS is an insurance plan that allowsconsumers to pay via payroll deductionswhile that individual is in the workforce. CLASS provides coverage beyond Medicarefor non-medically related services likedaily living care. Gives individuals more opportunities toreceive long-term care from home, instead ofin nursing homes or hospice.
YOUNGADULTCOVERAGE• Prior to the Affordable Care Act,insurance companies couldremove children from their parent’sinsurance at age 19.• Full time students or part-timeworkers in their 20’s often couldnot afford insurance.• The Affordable Care Act allowsthem to stay on parent’sinsurance until age 26.
EXCHANGEPROGRAM• Program designed to make buying privateor public health coverage easier for smallbusinesses and individuals.• 1 stop shop to… Compare health plans. Get answers to questions about healthcoverage options. Find out eligibility and which tax creditsmight apply to lower overall costs.
CO-OPPLANS• Consumer Operated and Oriented Plans• CO-OP is a new type of non-profit healthinsurance plan where insurers are run bycustomers. Individuals or small businesses elect board ofdirectors - made up of other CO-OP customers. Profits must be used to lower premiums andimprove benefits.•Individuals or small business owners can jointogether in creating a CO-OP withgovernment loans to get the CO-OP started.
ENDSABUSE• Protects againstcancellation ofcoverage, even afteran individual becomessick, due to applicationerrors.• Revamped appealprocess when paymentor care is denied.
• Protects againstpremium hikes.• Protects against pre-existing conditiondiscrimination.• Protects againstcharging higher ratesto women during theirreproductive years.ENDSABUSE
MOREAFFORDABLE• $25 million of federal funding will go tostates and communities for pregnant andparenting women and teens.• More lower income households will beeligible for Medicaid. $14,000 for individualsand $29,000 for families.• Medicare recipients and the elderly willhave access to free preventative care. Annual check-ups Cancer screening
• Lower & middle income individuals andfamilies = access to tax credits to assist themin paying for health insurance.• Small Businesses: Small businesses with 50 or employees,(96% of all businesses) no longer have toguarantee insurance because employeeswould have more options. If the small business chooses to offerinsurance, tax credits given to offset costs.MOREAFFORDABLE
ENHANCINGQUALITY• Partnerships forPatients• Better Care =Lower Costs A public-privatepartnership with the goalof preventing injuries andimproving care outcomes.
ENHANCINGQUALITY• Accountable Care Organizations willbe created to help coordinate careto lower costs and improve quality byclosing gaps in care and preventingduplicative care.• The Act has already provided morethan 130 million dollars for communitymedical centers for equipment andstaffing.
ONGOINGDEBATE• Is the Affordable Care Act good forAmerica?• Is it a "socialist“ and "unconstitutional"government takeover of the health caresystem?• Will it increase the cost of health care anddecrease the quality?• Will the law cost more than $2.5 trillionover 10 years and drive the US deeper intodebt???
WEBSITESYOUSHOULDKNOWhttp://www.healthcare.gov/index.htmlGovernment created website which provides in-depthexplanations of the Affordable Care Act, insuranceoptions and changes.http://younginvincibles.orgThis site was created by young adults, for youngadults. It encourages people from the age of 18 to 34to advocate for issues that affect them.http://www.healthcareandyou.org/what-is/This site was created by The Healthcare and YouCoalition and provides easy-to-understand informationabout the new health care law.
WHAT’SNEXT?• What did you learn?• What do you still need to figureout?• What will you do with theinformation?