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INCREASING NUMBER OF AMERICANS UNINSUREDINCREASING NUMBER OF AMERICANS UNINSURED
54 million people
47 million people
• Over 50 million people are uninsured
• An additional 72 million people have inadequate insurance
• Only 71%of small businesses with 10-24 workers and 48% of businesses with fewer than 10 workers offer coverage
WHAT PREVENTS PEOPLE FROM
GETTING ADEQUATE INSURANCE?
WHAT PREVENTS PEOPLE FROM
GETTING ADEQUATE INSURANCE?
THE SKYROCKETING COST OF HEALTH CARE
THE SKYROCKETING COST OF HEALTH CARE
The annual health care cost for an American family is
more than $20,728:That’s a new car!
Medical bills contribute to at least
62% of bankruptcies in the United States
30% OF HEALTH CARE COSTS ARE WASTED
30% OF HEALTH CARE COSTS ARE WASTED
Totaling over $600 billion$600 billion
More and more people can’t afford to see a doctor
EVEN IF YOU COULD AFFORD INSURANCE . . .
EVEN IF YOU COULD AFFORD INSURANCE . . .
Your children could only stay on your insurance until age 19 or until they finished school – whichever came first
Lifetime spending limits: once you became too expensive, insurance companies could stop paying for treatment
Insurance companies could drop coverage once you became sick
DIABETESASTHMA
HEART MURMURHEARTBURN
WAS ONCE PREGNANT
ALLERGIC TO PEANUTS
BACK PAIN
DEPRESSION
HIGH BLOOD PRESSURE
PRE-EXISTING =CONDITIONS
BIRTH DEFECT
HOW DO WE ENSURE ACCESS TO HIGH
QUALITY AND AFFORDABLE
HEALTH CARE?
HOW DO WE ENSURE ACCESS TO HIGH
QUALITY AND AFFORDABLE
HEALTH CARE?
32 million Americans will be insured
under the Affordable Care Act!
32 million Americans will be insured
under the Affordable Care Act!
HOW DO WE GET PEOPLE COVERED?
HOW DO WE GET PEOPLE COVERED?
Medicaid expansion
Tax credits for small businesses
Subsidies to buy into the exchange
Allowing over 5 million young adults to stay on their parents’ plan
HEALTH INSURANCE EXCHANGES
HEALTH INSURANCE EXCHANGES
• Creates a marketplace to compare health plans
• Open to everyone – required for members of Congress
• Standardizes a minimum benefits package to eliminate flimsy plans
• Increases transparency and negotiating ability
Begins on January 1st, 2014
= supermarkets for health insurance
INDIVIDUAL MANDATEINDIVIDUAL MANDATE
• If you have health insurance you are good to go
• If you cannot afford it, you will qualify for subsidies to purchase it in the exchange
• If you can afford it and still choose not to get it, you will pay a fine
NEW CONSUMER PROTECTIONSNEW CONSUMER PROTECTIONSProtect people from unfair insurance practicesProtect people from unfair insurance practices
Full implementation by 2014
No more lifetime limits on coverage
No “pre-existing condition” discrimination
80+% of premiums must be spent on care– or you get $$
back
No more discrimination
against womenby charging higher
rates
Starts January 1st, 2014
NEW CONSUMER PROTECTIONSNEW CONSUMER PROTECTIONSProtect people from unfair insurance practicesProtect people from unfair insurance practices
PREVENTION AND WELLNESSPREVENTION AND WELLNESSInvest in Prevention and Healthy Choices
*National Prevention Council will create a National Prevention Strategy.
*National Prevention Council will create a National Prevention Strategy.
Starts January 1st, 2014
THE ACA IS GOOD FOR DOCTORS
THE ACA IS GOOD FOR DOCTORS
Better care for
your patients
Better care for
your patients
Incentives for medical students to choose
PRIMARY CARE
Incentives for medical students to choose
PRIMARY CARE
WORKFORCE STRENGTHINGWORKFORCE STRENGTHING
Educational incentives established for:
– Doctors– Nurses– Other health care
professionals– Focus on Primary Care– MORE NEEDED!
Educational incentives established for:
– Doctors– Nurses– Other health care
professionals– Focus on Primary Care– MORE NEEDED!
GETTING MORE VALUE FOR OUR MONEY
GETTING MORE VALUE FOR OUR MONEY
Programs and incentives are put in place for doctors and hospitals to:
– Communicate better– Decrease
complications– Study what treatments
work best– Help patients stay
healthy/get well
Programs and incentives are put in place for doctors and hospitals to:
– Communicate better– Decrease
complications– Study what treatments
work best– Help patients stay
healthy/get well
REAL STORIES, REAL PEOPLEREAL STORIES, REAL PEOPLE
Baby Jax• He and his twin brother were
born in August of 2011• Jax was born with a genetic
disorder and a serious heart condition
• He underwent open heart surgery at only 2 months old
• His first day in the Neonatal Intensive Care Unit cost $150,000 – he stayed for 21 days
Baby Jax• He and his twin brother were
born in August of 2011• Jax was born with a genetic
disorder and a serious heart condition
• He underwent open heart surgery at only 2 months old
• His first day in the Neonatal Intensive Care Unit cost $150,000 – he stayed for 21 days
REAL STORIES, REAL PEOPLEREAL STORIES, REAL PEOPLEBaby Jax
• Thanks to the ACA, Jax’s family doesn’t have to worry about his “pre-existing” conditions
• They also don’t have to worry about reaching a lifetime cap on coverage – which he would have in his first year of life
• Jax’s family will be able to keep their house, pay their bills, and afford to care for all three of their children.
• Jax can live a healthy life and pursue his dreams.
Baby Jax• Thanks to the ACA, Jax’s family
doesn’t have to worry about his “pre-existing” conditions
• They also don’t have to worry about reaching a lifetime cap on coverage – which he would have in his first year of life
• Jax’s family will be able to keep their house, pay their bills, and afford to care for all three of their children.
• Jax can live a healthy life and pursue his dreams.
The ACA and the US
• 3.1M more young adults are now covered under their parents’ plan
• 5.2M Medicare beneficiaries received $3.9M in drug rebates to close the ‘donut hole’
• 54M more Americans received free preventative services
• 12.8M Americans have qualified for a $1.1B rebate from insurance companies
THE ACA IS AT RISKTHE ACA IS AT RISK
• Politicians are endangering your health for political gain, calling for repeal
• If the ACA is compromised…
Jax could lose his insurance based on
his pre-existing condition and lifetime
spending limit.
THE ACA IS AT RISKTHE ACA IS AT RISK
A 23 year old graduate looking for a job will no longer be insured through her parents
THE ACA IS AT RISKTHE ACA IS AT RISK
A 60 year old grandmother with breast cancer will reach her lifetime
insurance limit and be denied life saving treatment
Families will continue to struggle with medical bills
WHAT CAN YOU DO?WHAT CAN YOU DO?• Contact your elected officials,
asking them to protect the ACA
• Tell a friend what you learned
today
• Invite one of our members to give
a presentation
• Learn about healthy choices for everyday life
• Continue to be informed about your health care
• Take advantage of preventive care offered through the ACA