The Patient Protection and Affordable Care Act

Our Healthcare Reform Law

Why do we need it?

What does it do for us?

The Problem

• 50 million people uninsured

• Costs rising

• Fragmented coverage and care

• Insurance company practices don’t cover “pre-existing conditions” lifetime and annual limits drop people when they get sick

Possible Solutions?

Right

Tax Credits

• free market

• doesn’t solve all the problems

Left

Single payer

• big government

• “non-starter” in this political environment

Solution

• Build on current system

Mix of public and private

• Fix the problems

Increase access and affordability

New System

3 major changes:

1. Reformed insurance markets to increase coverage

2. Individual responsibility to get coverage (mandate)

3. Help those who can’t afford insurance

All 3 needed to make it work

1. Reformed Insurance Market

• Can’t refuse people with pre-existing conditions (kids now, adults in 2014)

• Can’t drop you if you get sick

• No lifetime limit on benefits

• No annual limit on benefits (2014)

• Government oversight of premium rates and how premium dollars are spent

2. Individual Responsibility

• Everyone must have insurance (2014)

• Most will still get from employers

• State “exchanges” easier to find information about plans plans must meet standards choices members of Congress will use same plans

3. Help for those who can’t afford insurance

• Medicaid expanded

• Federal tax credits

Small businesses Families earning up to 400% of

federal poverty level (2014)

All 3 needed to work

Insurance reforms

Individual responsibility

Help with cost

Medicare

• Help seniors with prescription drug cost 50% discount on brand drugs reduced cost for generic drugs gradually close the “doughnut hole”

• No-cost preventive care• Higher reimbursements for some primary

care doctors• Pilot programs for better care, better value

Costs

How do we, all of us, pay for improvements?

Everyone gets insurance Hospitals save $ (fewer uninsured people)More efficient payment systems save $

(and improve quality)Higher Medicare taxes on higher earnersTaxes on medical device companiesTaxes on tanning salons!

What Can We Expect?

• Easier for people to get, and keep, health insurance. More people will be insured.

• New rules for insurance companies make them more accountable.

• Overall healthcare system works better, due to emphasis on preventive, primary, and coordinated care.

• Better system = healthier people = less healthcare costs

More Information

• healthreform.kff.org/the-animation.aspx

• www.healthcareandyou.org

• www.healthcare.gov