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Health Care Reform
Transcript of Health Care Reform
WHY THE CONFUSION?
of people say that the most effective form of receiving information about health care reform is:
is when the ACA was signed into law.
It remains in effect today.
of uninsured people do not believe they have enough information
to understand how health care reform will affect them
are unaware that the Affordable Care Act—health care reform—is still the law of the land, including the
of Americans who believe it has been repealed!
4 in 10 Americans
conversations with friends and family
And at pages,
that’s a lot to talk about!
PPACA (Patient Protection
and Affordable Care Act)
Health Care and Education
Reconciliation Act of 2010
The Affordable Care Act
THE BIG PICTURE
THE GOALS OF
HEALTH CARE REFORM:
1. Provide health care coverage to more people.
2. Lower costs of health care over time.
National health expenditures
totaled an estimated
It is expected that health care expenditures will reach
by 2019 by growing at a rate of
THE BIG CHANGES
FOR 2014 AND BEYOND
What is the Individual Mandate?
The individual mandate will take effect January 1, 2014 and will require most Americans to have health insurance or potentially pay a penalty.
Coverage has to include essential benefits, which are a set of health care service categories that must be covered by certain plans.
THE PENALTY BOX
$95 per adult and $47.50 per child (up to $295 per family) or 1% of family income, whichever is greater
$325 per adult and $162.50 per child (up to $975 per family) or 2% of family income, whichever is greater
For 2016 and beyond:
$695 per adult and $347.50 per child (up to $2,085 per family) or 2.5% of family income, whichever is greater
The tax penalty for not having insurance will vary over the next 3 years:
JUST THE ESSENTIALS
Essential benefits offered through ACA:
1. Ambulatory patient services
3. Emergency services
4. Maternity and newborn care
5. Chronic disease management, and preventive and wellness services
6. Mental health and substance use disorder services, including behavioral health treatment
7. Prescription drugs
8. Rehabilitative and habilitative services and devices
9. Laboratory services
10. Pediatric services, including oral and vision care
1. This competitive marketplace, also known as an exchange, will be where individuals can compare and purchase coverage.
2. It will primarily serve individuals buying insurance on their own without access to coverage through an employer, spouse, or public plan like Medicaid.
YOUR HEALTH INSURANCE MARKETPLACE
What are the Health insurance market places?
The different levels of coverage offered through the marketplace are:
Bronze (individual pays 40% of costs)
Silver (individual pays 30% of costs)
Gold (Individual pays 20% of costs)
Platinum (individual pays 10% of costs)
What's Available on the
Health Insurance Marketplaces?
IMPORTANT TO KNOW:
What is a Variable Hour Employee?
A variable hour employee is someone whose employer cannot determine whether the employee is expected to be employed on average of at least
per week. The work hours are
hours a week is average number of hours you have to work per week to become full-time benefits eligible.
employees are expected to be newly eligible for health care coverage
Want to find out more?
A federal government website managed by the U.S. Department of Health and Human Services
Sponsored by the Kaiser Family Foundation, a non-profit, private operating foundation focusing on the major health care issues facing the U.S.