The Affordable Care Act Making health care more secure and returning control to consumers
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Our Health Care Principles 1.
Every American should have the freedom to control their own medical decisions without interference from insurance companies.
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Everyone should have health security, – the right to purchase quality coverage at a fair and affordable price.
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Health insurance industry discrimination against people with preexisting conditions violates fundamental rights
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Every American should have the opportunity to change jobs or start a small business without losing health insurance.
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The Affordable Care Act The new national health care law, achieves these principles --Passed March 23, 2010 --Reforms Come in 2 Stages But first, we’re talking about this because…
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The Affordable Care Act is based on the fair proposition that when health care is made affordable people should be personally responsible for getting coverage, rather than shifting costs onto the rest of us. Now that the majority of the Supreme Court has ruled the law constitutional, it is time to move forward and get down to the task of making quality health care affordable for4 everyone.
Stages of Reform Stage 1 (in effect now) • Outlaws some of the worst insurance abuses • Requires accountability from insurance companies Stage 2 (goes into effect 2014 • Guarantees every American has a place to go to get quality affordable health coverage • Permanently outlaws health insurance industry discrimination • Requires Members of Congress to buy the 5 same plans offered to us.
Stage 1 Reforms Insurance Practices Outlawed now under the Affordable Care Act
• Preexisting condition exclusions (kids now/everyone in 2014) • Lifetime limits • Using loopholes & fine print to deny claims • Dropping coverage after a person gets sick
• Excessive insurance industry profits and overhead (80-85% of your premium dollars must be spent on medical care, not profits)
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Stage 1 Reforms The Affordable Care Act guarantees • Preventive care coverage & screenings with no co-pays or deductibles • Young adults can stay on parents policies until age 26 • Preventive care without cost sharing for seniors on Medicare 7
The Faces of Reform How the Affordable Care Act is already helping people across Wisconsin who would otherwise be the victims of health insurance discrimination 8
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 . 9
Stage 2: Guaranteed Affordable Health Care (2014) They can never take away!
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The Affordable Care Act Ends Discrimination for 1.3 Million Wisconsinites Under 65 • More than 1.3 million Wisconsinites under the age of 65 have been diagnosed with pre-existing conditions that, without health reform, could lead to denials of coverage or discriminatory rates. • As we age, the risk of insurance industry discrimination escalates. 11
Just Some of the Examples of Preexisting Conditions
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Competitive Health Marketplace for Middle Class • Open to all Americans who don’t have affordable health coverage options now or in the future. • Created by each state, or federal government if state refuses • You choose your own private insurance on a website, like Travelocity or Consumer Reports. • Consumers in control, with clear information and real competition. • Members of Congress offered same choices we have. 13
Competitive Health Marketplace for Middle Class • Makes coverage more secure: bans denials of coverage due to preexisting conditions or dropping coverage when someone get sick. • Makes coverage more affordable: generous premium tax credits on a sliding scale. • Creates new options, such as a nonprofit member owned health insurance cooperative. • Bans discriminatory pricing based on medical condition, age, or gender.
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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.
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Gurantees BadgerCare to low income Wisconsinites • No more loopholes, complicated eligibility requirements, waiting lists: everyone below the income line gets BadgerCare. • Medicaid (BadgerCare) expansion paid for by the Feds, so Wisconsin saves billions. • HOWEVER: The Supreme Court gave states the right to reject the additional federal money for Medicaid (BadgerCare). 16
Strengthen Medicare The Affordable Care Act protects Medicare benefits and strengthens the program for future generations by • cracking down on waste, fraud, and abuse in Medicare, • ending handouts to insurance companies, and • providing free preventive care to decrease costly emergency room visits and reduce health care costs long-term. 17
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 18
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 19
The Choice • There are only two serious approaches to health care on the table: • Option 1: Continue to implement the Affordable Care Act, which is already protecting us and will guarantee greater security and freedom.
• Option 2: Repeal ACA, and allow insurance companies to control our health care options: enabling them to continue to jack up premiums and profit by preexisting condition and gender 20 discrimination.
The Affordable Care Act is Worth Protecting Insurance companies must now play fairly. It’s the law. •
PROTECTION: Working families no longer can be denied coverage for preexisting conditions, risk losing their coverage when they get sick or hit a “lifetime limit”
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PREVENTION: Preventative care must be covered free of charge by insurance companies--including mammograms for women and wellness visits for seniors.
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The Affordable Care Act is Worth Protecting Insurance companies must now play fairly. It’s the law. •
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FAIRNESS: Millions of Americans will receive a rebate because their insurance company spent too much of their premium on administrative costs or CEO bonuses. PEACE OF MIND: Families will not be forced into bankruptcy when someone gets sick, and can get affordable coverage no matter where they choose to work or what gender they are; with no loopholes or fine print in your policy! 22
The Affordable Care Act is Worth Protecting Insurance companies must now play fairly.
It’s the law. •
PROTECTION: Working families no longer can be denied coverage for preexisting conditions, risk lose their coverage when they get sick or hit a “lifetime limit”
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PREVENTION: Preventive care must be covered free of charge by insurance companies--including mammograms for women and wellness visits for seniors. 23
Questions? • Kevin Kane Healthcare Organizer Citizen Action of Wisconsin
414 550 8280 (cell)
[email protected] facebook.com/got.healthcare GotHealthcareWI.com 24
