AFFORDABLE CARE ACT

▲ New Choices…More Coverage

HOSA - Future Health Professionals6021 Morriss Road, Suite 111Flower Mound, TX 75028800-321-HOSAwww.hosa.orgUsed with permission from National HOSA

MAJOR

CHANGE

S

Compared to the current healthcare system in America, the Affordable Care Act provides:

• Expanded Access. • Ends Abuse. • More Affordable. • Enhanced Quality.

EXPAND

ED 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

PRE-EXIST

ING 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.

COMMUNI

TY CARE CENT

ERS

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.

LONG TERM CARE OPTIONS

• Creates a program CommunityLiving 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.

YOUNG

ADULT

COVERAGE

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

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.

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.

ENDS ABUS

E

• Protects against cancellation of coverage, even after an individual becomes sick, due to application errors.

• Revamped appeal process when payment or care is denied.

• Protects against premium hikes.

• Protects against pre-existing condition discrimination.

• Protects against charging higher rates to women during their reproductive years.

ENDS ABUS

E

MORE AFFORDAB

LE

• $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

• 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.

MORE AFFORDAB

LE

ENHANCI

NG QUALITY

• Partnerships for Patients• Better Care = Lower Costs

A public-private partnership with the goal of preventing injuries and improving care outcomes.

ENHANCI

NG 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.

ONGOING DEBA

TE

• 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?

??

WEBSITE

S YOU SHOULD KNO

W

http://www.healthcare.gov/index.htmlGovernment created website which provides in-depth explanations of the Affordable Care Act, insurance options and changes.

http://younginvincibles.orgThis 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.

WHAT’

S NEX

T?

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