Health Reform and Young AdultsWhat do you need to know?
YOUR NAME HEREYour Organization
Raising Women’s VoicesFall 2010
Why did we need national health care reform?
• Too many people have no health insurance coverage. More than 50 million people nationwide are uninsured.
• People are losing coverage, or have gaps in their coverage
Insurance companies run the show!
• It’s difficult to know what your policy covers and what it doesn’t.
• There are often hidden clauses, such as $$ limits on the amount of medical care that will be covered or refusals to cover pre-existing conditions.
• In some states, insurers charge women more than men.
So, what happened?• President Obama signed the Patient
Protection and Affordable Care Act (PPACA) on March 23, 2010
• The provisions in the health care bill will be implemented in phases from now until 2014.
• Several very important provisions go into effect September 23, 2010
A health reform owner’s manual for young adults
• Why is it important ?• How does it work?
• How does the law help young adults?• What’s in it for young women?
Why should young people care?
• As of March 2009, 18.9 million young adults were uninsured.
• Young people do get sick.• It’s about cost, stupid.• We have to speak up for our right to health
care.
Young adults: What’s been going on?
• “Aging out” of our family health insurance policies before we have our own insurance.
• College health insurance policies that are expensive and inadequate.
• Being unable to find entry-level jobs that offer health insurance, once we graduate.
Now, we can stay on our parents’ insurance
Starting September 23, 2010:• We can stay our parents’ health insurance until we
are 26 years old.• We don’t need to live at home.• We don’t need to be financially dependent on our
parents.• We can even be married (except that a spouse is not
eligible for the coverage – just you).• The only exception is that if you have a job where
you are offered health insurance, you can’t stay on your parents’ policy .
What do I or my parents need to do?• Contact the human resources department
where your parents work and let them know you’d like to stay on your parents’ plan. Call them NOW – you may have only a limited amount of time to enroll.
• Contact your parents’ health insurance provider and ask about any additional steps you have to take.
• Deadline: Make sure to find out what the deadline is for making this request – you may not have too much time!
Who will pay for me to stay on my family health insurance plan?
• Under employer plans, the employee typically pays a share of the premium and the employer pays the rest.
• Therefore, the bill will probably still go to your parents.
• Currently 96% of all college/university plans have caps on the amount of medical care they will cover. This means that if you have a catastrophic accident or really serious illness, you may run out of coverage once the medical bills hit $500,000 or $1 million.
• This practice is eliminated in the new health reform law.
• BUT! It’s unclear whether the new law will apply to all college health care plans.
• We’re going to have to make sure our college health plans follow the new law.
What about those expensive, inadequate college health plans?
• STARTING NOW: Small businesses (which employ largely young adults) will receive tax credits to help them offer insurance.
• IN 2014: Large employers will be encouraged to offer employee coverage, or else face a fine.
• IN 2014: If the premium you pay for coverage through your work is too high, you may be able to get cheaper coverage elsewhere.
Getting a job with health insurance
What else should we know?What’s next?
• Between now and 2014 is a really important time for health care reform.
• States and the federal government will be developing new regulations, processes and even agencies to carry it out.
• In 2014, the new health reform law will go into effect, hopefully with all the components that it needs to be fair and accessible.
States open insurance “exchanges”
• Each state will have a website and telephone hotline to help individuals and small businesses purchase and enroll into “qualified health plans.
Comparing apples to applesProvides information on each plan in a standard format, including:– Monthly cost and co-pays– Plan performance on quality
measures– Plan ratings by quality and price– Information on current customer
satisfaction
More low-income people will beeligible for public coverage
• An estimated 16 million more Americans will qualify for Medicaid coverage. Almost 8 million uninsured young people could benefit.
• Income eligibility goes up to 133% of federal poverty level which is $14,400 for individuals or $29,327 for a family of four.
Moderate-income people get help to buy coverage
• People with incomes up to 400% of federal poverty limit get subsidies on a sliding scale to help them buy private insurance.
• That’s an income of up to $43,000 for a single individual.
What role will employers play?• Employers will be encouraged to provide
coverage for their workers. • Those who don’t will face a fine of $2,000 for
each uninsured employee who buys coverage in the exchange using federal subsidies.
• Small businesses up to 100 workers can shop in the exchange and get larger tax credits to help them afford to cover workers.
Insurance ref gets new powers
• No denials of coverage to adults with pre-existing conditions.
• No charging women more than men.
• No annual limits on coverage.
What is our personal responsibility?• As of 2014, we must carry health insurance,
just like car insurance.• If we don’t, we face a fine of $95 a year or 1%
of household income in 2014. This gradually increases over time.
• Exemptions for low-income households, financial hardship, religious objections.
What about young women in particular?
Taking effect immediately:– Maternity coverage is mandated. – Licensed practitioners serving
women using free-standing birthing centers become eligible for Medicaid reimbursement
– Requirement that employers provide breastfeeding women with break time and private space to express milk.
– Women’s Health Amendment waives co-pays for certain preventive services.
Ambivalence about sex-ed and contraception
• New funds for comprehensive sex education and abstinence-only ed.
• No guarantee birth control will be deemed a “preventive service” exempt from co-pays.
What’s not so good for women’s health?
• Continued ban on use of federal funds to pay for abortions. Women on Medicaid will not be able to use their government funded coverage for abortion services (except in case of rape, incest or threat to life).
• Community health centers cannot provide federally subsidized abortion services
• States may ban abortion coverage in their state exchanges.
• If abortion coverage is offered in the exchange, federal subsidies must be segregated and not used for that purpose.
Is health reform perfect?• No. There’s a lot for us to work on.• For example, immigrants are excluded from many
provisions. Undocumented immigrants can’t even purchase health coverage in the exchanges using their own money.
• The subsidies may not be enough to make insurance affordable.
• The cost of health reform could be more than expected.
How can YOU get more involved? 1. Host an education session with your local
community and organization
2. Just tell your friends and family members what health care reform really means, ask for more materials from us!
3. Come to RWV events and join our mailing list!
Raising Women’s Voices is here to keep you updated on health reform
• Visit our website at www.raisingwomensvoices.net
• Sign up for newsletter and alerts by contacting [email protected]
