The Affordable Care Act:

“Take Health Care into Your Own Hands”

• Parichhit Basnet• Ashley Berry• Alena Boynton• Ebony Fortier

• Neviesh Perry• Kelli Reynolds• Orlisha Starks• DeAndre Turner

Objectives:

• Educate public about the Affordable Care Act• Inform public about insurance issues• Discuss what is being done now and what is

expected to change• Educate public about the present and future

services covered under the Affordable Care Act.

History of the Affordable Care Act

• Affordable Care Act was passed by President Obama in March 2010

• Fifty million Americans were uninsured before the passing of the Affordable Care Act

History of the Affordable Care Act

• What does the act do? Creates a new patient bill of rights which:–Protects from insurance company abuse–Makes health care more affordable–Provides better access to care–Strengthens Medicare services

Health Insurance Issues

• In the Past:– Insurance companies only spent 60%

of premium dollars on health care– Insurance companies could raise

premiums to increase their profit without justification to its providers

– Insurance companies could deny coverage due to pre-existing health conditions

– Those on Medicare paid out of pocket costs due to gaps in coverage

Health Insurance Issues

• Now:– 80/20 Rule: Insurance companies are now required

to spend 80% of premium dollars on health care – Young adults under the age of 26 can now stay on

their parents’ health plans– New plans are being implemented in every state for

people who have been denied health insurance because of a pre-existing condition

– Insurance must publicly justify their actions if they want to raise premiums by 10% or more

Health Insurance Issues

• Now Cont’d:– Prohibits insurance companies from putting

lifetime caps on the dollar amount that they will spend on benefits

– Coverage cannot be denied to women because they are pregnant, gave birth by c-section, are a breast cancer survivor, or are a victim of domestic violence

–Medicare provides rebates to beneficiaries who pay out of pocket healthcare expenses

Covered Services for Children & Adolescents

• Services currently offered:– Immunization– Vision and hearing screenings– Oral health– Well-baby visits– Well woman’s exams– STD screening and prevention

• Services coming in 2014:– Autism screening– Blood pressure screening– Alcohol and drug use assessments for

adolescents– Behavioral assessments

Covered Services for Adults

• Services currently offered:– Immunizations– Alcohol and tobacco misuse screening

and cessation counseling– HIV and STD screening and

prevention• Services coming in 2014:

– Blood pressure screening– Cholesterol screening– Depression screening– Type II Diabetes mellitus screening– Diet and obesity screening and

counseling

How it Affects Women

• Women are the primary care takers of family

• Women often make the health care decisions for their families

• Women have unique health care needs

• Women are more likely to be unemployed and live in poverty

• The Affordable Care Act protects women

Covered Services for Women

• Services currently offered:– Mammograms– HIV/STD screening– Well-woman exams– Contraception– Screening for gestational diabetes– Breast feeding education and resources– Interpersonal and domestic violence referrals

• Services coming in 2014:– Colonoscopy

What to expect in the future: Year 2014

• It will be illegal for insurance companies to deny coverage due to a pre-existing condition

• Insurance companies will not be able to charge women more than men

• Tax credits will be available to help middle class families afford health insurance

What to Expect in the future: Year 2014 Cont’d

• There will be new state-based marketplaces for insurance companies.

• Medicare gaps will no longer exist

• Medicaid will be extended to Americans with low incomes of up to $14,000 for an individual or $29,000 for a family of four

Qualifications & Application

• Meet Medicare and Medicaid qualifications– Apply at local health department– Apply at my soonercare.gov

• Able to qualify through community health clinics based on income to receive affordable care

• Complete implementation of the Affordable Act and applications will be available in 2014

References

• http://www.healthcare.gov/blog/2012/03/anniversary032312.html

• Whitehouse.gov/healthreform