Benefitting Idahoans

PATIENT PROTECTION AND AFFORDABLE CARE ACT

Farm field outside Moscow, Idaho

Scholarships and Loan Repayment for Rural Practitioners

• 17% of Idaho residents live in an underserved area (“The Affordable Care Act: Immediate Benefits for Idaho”).

• The Affordable Care Act allocates 1.5 billion in funding for the National Health Service Corps which provides scholarships and loan repayments for health professionals who commit to work in underserved areas (“Health Reform for Rural Americans”, 2010).

• The Act provides also resources to medical schools to train physicians to work in rural areas (“Health Reform for Rural Americans”, 2010).

Addressing Medicare

• The Act will close the Medicare prescription drug coverage gap (the donut hole) by 2020. In 2010, the government provided tax free rebates of $250 to recipients who hit this gap. In Idaho, more than 16, 559 people received these rebates (“Affordable Care Act in Your State: Idaho”, 2011).

• The Affordable Care Act extends free preventative benefits and wellness exams to people with Medicare, benefitting almost 230,000 Idahoans (“Affordable Care Act in Your State: Idaho”, 2011).

• The Act allocates $350 million over 10 years towards fraud prevention and detection (“Strengthening Medicare”, 2010). Between 2010-2011, the government recovered almost $7 billion in health care fraud (“Campaign to Cut Waste”, 2011, Russo, 2011).

Expansion of Medicaid

• Medicaid is expanded to include those making up to 133% of the poverty level regardless of familial status (Sorian, 2011).

• Expands the Money Follows the Person Program through September 2016 (“Money Follows the Person [MFP]”). Idaho has been given $6.5 million in grants for this program (“Affordable Care Act in Your State: Idaho”, 2011.)

Pre-existing Conditions• The Act currently prohibits denying coverage to children under 19

due to pre-existing conditions (“Key Features of the Affordable Care Act, By Year: 2010”, 2010).

• Establishes a Pre-Existing Condition Insurance Plan for Individuals who have been denied coverage due to their health condition (“Key Features of the Affordable Care Act, By Year:2010”, 2010).

• Premiums are based on age and choice of plan. In Idaho, they range from $133-$571/mo. Out of pocket expenses are capped at $7,000 per year for out-of-network, and as low as $4,000 for in-network care (“Pre-Existing Condition Insurance Plan: Idaho”).

• Effective 2014, insurance companies will no longer be able to deny coverage based on pre-existing conditions, nor will they be able to charge higher premiums based on gender or health (“Key Features of the Affordable Care Act, By Year: 2014”, 2010).

Preventative Care

• The Act extends free preventative care services to individuals with plans starting after September 23, 2010. Individuals may opt to keep a grandfathered plan which is not required to provide these benefits (“Preventative Care”, 2012).

• Examples of preventative services include well child visits, vaccines, blood pressure tests, certain cancer screenings, and contraceptives(“Preventative Services Covered”,2011).

“An ounce of prevention is worth a pound of cure.”

ReferencesThe affordable care act: Immediate benefits for Idaho. Retrieved from

http://www.healthreform.gov/reports/statehealthreform/idaho.html

Affordable care act in your state: Idaho. (2011). Retrieved from http://www.healthcare.gov/law/resources/id.html

Health reform for rural Americans: The affordable care act gives rural Americans greater control over their own health care. (2010). Retrieved from http://www.whitehouse.gov/files/documents/health_reform_for_rural_americans.pdf

Key features of the affordable care act by year. (2010). Retrieved from http://www.healthcare.gov/law/timeline/full.html#2010

Money follows the person (MFP). Retrieved from http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Balancing/Money-Follows-the-Person.html

Pre-existing condition insurance plan: Idaho. Retrieved from http://www.healthcare.gov/law/features/choices/pre-existing-condition-insurance-plan/id.html

Preventative care. (2012). Retrieved from http://www.healthcare.gov/law/features/rights/preventive-care/index.html

Preventative services covered under the affordable care act. (2011). Retrieved from http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html

Russo, T. (2011, January 24 ). $4 billion in taxpayer dollars recovered. [web log post]. Retrieved from http://blogs.usdoj.gov/blog/archives/1157

Sorian, R. (2011, June 21). Medicaid and the affordable care act. [web log post]. Retrieved from http://www.healthcare.gov/blog/2011/06/medicaid06212011a.html

Strengthening Medicare. (2010). Retrieved from http://www.healthcare.gov/law/features/65-older/strengthening-medicare/index.html

US Department of Health and Human Services. (2011). Campaign to cut waste: Vice president Biden announces U.S. will halt production of excess dollar coins and Department of Justice recovered a record $5.6 billion in fraud in 2011. [news release]. Retrieved from http://www.hhs.gov/news/press/2011pres/12/20111213a.html#fraud