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WHAT IT MEANS FOR YOU?

April 2012

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Health Access is the leading voice for health care consumers in California.Founded in 1987, Health Access is the statewide health care consumer advocacy

coalition advocating for quality, affordable health care for all Californians.

OUR AGENDA in 2011 and beyond includes:

Preserving access to careFighting budget cuts to deny care and coverage to Californians;

Providing consumer protections Working to protect consumers against medical debt and abusive practices by insurers, providers, and others in the health care industry; and

Expanding coverage, Implementing and Improving the ACA for CaliforniaOrganizing for quality, affordable coverage for all, at both the state and federal level.

Health AccessHealth Access

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Why is Reform Important?An estimated 49 million Americans were uninsured in 2010,

8 million in California.Californians are more likely to have to buy insurance on their

own in the individual market.California and other states have made drastic cuts to public

health care programs.Insurance Companies have been allowed to put profits before

people – increasing premiums and denying coverage

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What is Federal Health Reform?The Patient Protection and Affordable Care Act was signed

into law by President Obama on March 23, 2010.

The purpose of this law is to address the worst problems in our health care system today by:Increasing Access and Improving AffordabilityEnacting Insurance Regulations and Consumer ProtectionsControlling Costs in the health care system.

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How Does Reform Help You?The Health Reform Bill will impact different people in

different ways. There are some provisions that will help everyone, but other provisions are tailored specifically to help young people, middle class families and individuals, small businesses, people with pre-existing conditions and serious chronic illnesses, and seniors.

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How Does Reform Help Seniors?Increased options for older Americans not yet eligible for

Medicare (through the Exchange)Limits Age Rating by Insurance CompaniesEnds discrimination based on pre-existing conditionsMedicare Improvements:

Donut hole, 2010: $250 rebates, 2011: 50% discountNo More Cost Sharing for Prevention and WellnessBetter oversight and reduction of waste, fraud, abuseExtending Medicare solvency for 10 years

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How Does Health Reform Help People Who Have Insurance? Nothing requires you to change your existing policy; but it will

make your coverage more secure and stable by:Requiring employers to continue offering coverage or

contribute to coverage through the ExchangeEnsuring you can still get coverage even if your life situation

changes (job change, divorce, graduation)Setting minimum standards for what benefits must be

included in insurance plansStabilizing and fixing the “individual insurance market”Bringing down overall costs to eliminate the “hidden tax”Improving Medicare and expanding Medicaid

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How Does Health Reform Help People Who Don’t Have Insurance?Expansion of Medicaid (Medi Cal in California)Employers will be required to provide or contribute to

insurance coverageInsurance Regulations prohibit discrimination against

people with pre-existing conditionsThe Insurance Exchange will make it simple and

convenient for individuals and small businesses to access affordability subsidies and tax credits

The Exchange will allow participants to access quality and affordable insurance

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What Reforms Already in Place Small business tax credits of up to 35%Rebates, beginning to close the Medicare Part D Donut HoleEnding discrimination against children with pre-existing conditionsEnd of RescissionsBan on lifetime and annual limits on coveragePreventive care covered (no cost sharing)Expansion of High Risk PoolYoung Adults covered through parents up to age 26Increased funding for Community Clinics

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The Supreme Court hearing… How did we get hear?

Repeal Vote House of Representatives voted to repeal the ACA Senate voted down repeal President Obama stated he would veto a repeal bill

Court Challenges Dozens of courts ruled in favor of ACA, a couple ruled

against the individual mandate but upheld the law and Medicaid expansion

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Supreme Court hearing Take-ways Historic three day history hearing Aggressive questioning from conservative

justices Remain confident in the constitutionality and

that it will be upheld Three possible scenariosCalifornia will continue with healthcare

reform regardless of the Supreme Court outcome

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What’s Next?Advocacy is still needed in the implementation process as

federal and state regulations are finalized.We have the opportunity to go beyond federal law and

improve reform to better reflects our needs and values.Areas that still need to be addressed include:

Rate RegulationPublic OptionBenefit Mandates: maternity, mental health, substance abuse

(Governor signed this bill in 9/2011)Eligibility/Enrollment (Governor signed this bill in 9/2011)Populations left out of ACA

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What Can You Do?Share your story – we need your stories in order to remind

legislators and the media why this is importantCall Congress – 888-876-6242Speak Up! Share what you’ve learned with your colleagues,

clients, friends and family.Stay Informed – get updates and alerts from Health Access :

www.health-access.orgwww.facebook.com/healthaccesswww.twitter.com/healthaccess