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Affordable Care Act
Transcript of Affordable Care Act
American's whose state did not expand Medicaid
Adults who do not seek coverage
Why is this a public health issue?
What is currently being done?
Key Terms to remember!
Trends Over Time
Medicaid eligibility expands to 138% of the Federal Poverty level, covering about half of the nations uninsured.
Therefore, more hospitals and doctors must take more medicaid patients in the coming years.
More people are expected to sign up during this open enrollment period because people now have more knowledge on the subject and more resources.
For Small businesses, there is a decrease in group plans but an increase in individual plans.
There will be lots of competition between insurance companies. This benefits consumers due to better insurance plans
5.7 million people will be uninsured in 2016 because 24 States have not expanded Medicaid.
Obama Care And The Uninsured
Affordable Care Act
• Increase the number of in-person assistance and resources for enrollment navigators
Who is involved?
Health and Human Services (HHS)
Awarded $54.6 million in the affordable care act mental health services
Center for medicare and medicaid services (CMS)
U.S. Department of the Treasury
Centers for Disease Control (CDC)
Food & Drug Administration (FDA)
What are their key functions?
Act upon the voting processes and approve any changes or reforms that are a part of U.S health legislation. These government officials also proposed bill changes which are fair and feasible to the state.
Health Agencies Involved
|Presented By |
Advisory board for multi-state health plans
Agency for Healthcare Research and Quality Office
Board of Governors for Patient-Centered Outcomes Research Institute
Grant Programs- Navigator Grant
Health Resources and Services Administration
National Prevention, Health Promotion, and Public Health Council
Pregnancy Assistance Fund
Substance Abuse and Mental Health Services Administration Office
Designed to keep the 3 branches of government in equal power. As a way to ensure that all parties are rightfully represented and fairly treated.
Covered California & the Navigator Grant
California's health exchange network for the Affordable Care Act
Uninsured individuals in 2015 will have to pay the higher of more than double what the penalties in 2014.
$95 or 1% of income
$325 or 2% of income
Estimated to have a total of 13 million people enrolled in exchange plan coverage in 2015
ACA mandated changes
Small Business Tax Credits
Better Protection Against Health Care Fraud
Discounts and Enhanced coverage for Senior Citizens
How it works!
Each State must implement three provisions to lower the rate of the uninsured
State Based Exchanges (Marketplace)
Expansion of Medicaid
No exploited rates for pre-existing conditions
Rate Equality for Men & Women
1 Free Preventative Care Services
(immunizations, pap-smears, mammograms, prevention screenings for HIV, Hep B)
Extended Coverage For Young Adults- Age 26
What to Expect
16,000 : New Primary Care Providers will be funded
over 1,000 : New Healthcare centers will be created
$11 billion : will be used to Fund Current Health Centers
$250 million : will be used to Expand the Primary Care Workforce & Enhancing the Number of Providers Available in Under served Areas
Currently Enrolled Statistics
8 million Americans enrolled in a marketplace plan during open enrollment 2014 (Oct 1st, 2013 – March 31st, 2014)
Of the more than 8 million:
◦54 percent are female and 46 percent are male;
◦34 percent are under age 35;
◦28 percent are between the ages of 18 and 34;
◦65 percent selected a Silver plan, while 20 percent selected a Bronze plan; and,
◦85 percent selected a plan with financial assistance.
7 million Americans enrolled in Medicaid and CHIP with about 1.5 million waiting for their enrollment to go through
About 2.6 million young people under 26 were able to enroll or stay in their parents plan
The Congressional Budget Office
To oversee discussions of all things pertaining to ACA. Including conversations that deal with patients rates for premiums, expenses for procedures, and coverage for services and medications.
1. Obama Care/Affordable Care Act: A federal statute signed into law in March 2010 as a part of the healthcare reform agenda of the Obama administration.
2. Medicaid: A joint federal and state program that helps low-income individuals or families pay for the costs associated with long-term medical and custodial care provided if they qualify. Although largely funded by the federal government, Medicaid is run by the state where coverage may vary.
3. Medi-cal: Is what the federal Medicaid program is called in California which is essentially the same thing as Medicaid
4. Medicare: Is the federal program which provides basic health insurance to everyone over the age of 65
5. Employer mandate : The new health care reform Legislation requires employers with 50 or more employees to provide health coverage to those employees, and it also sets a minimum of coverage and employers contributions
6. Marketplace plan: All health plans purchased through the marketplace (sometimes called an exchange) will qualify as minimum essential coverage (meaning you won't have to pay the fee for not having insurance). You can also find out if you qualify for Medicaid, CHIP or Medicare through your State’s marketplace.
7. Insurance Premiums : Agreed upon fees paid for coverage of medical benefits for a defined benefit period.
Under the ACA's Mandate
In the next 5 years
In 1 year
Premium rates are coming to a slow
Aids in public promotion, awareness of deadlines and changes, gives the consumer the ability to compare insurance plans, directs you to the market place, and is your go to provider for all information pertaining to the Affordable Care Act
Provide well-developed awareness campaign about the availability of tax credits
• Create applications in multiple languages (beyond English and Spanish.)
• Strengthen coordination among the marketplaces and Medicaid to prevent applications from being lost or unduly delayed.
Make sure to do your research before you buy your health insurance
The number of uninsured adults dropped the most from 28% to 18%
For states that expanded medicaid, the rate for people in poverty fell from 28% to 17%
For states who did not expand on medicaid, there was no significant change from 38% to 36%
60% of people with new coverage visited a doctor or other provider, went to a hospital, or paid for a prescription.
6 of 10 people said they would not have been able to access or afford this care before the ACA
Strengthen coordination among the marketplaces and Medicaid to prevent applications from being lost or unduly delayed.
In regards to the uninsured states