The Affordable Care Act
Making health care more secure and
returning control to consumers
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Our Health Care
Principles
1.
Every American should have the freedom to
control their own medical decisions without
interference from insurance companies.
2.
Everyone should have health security, – the right
to purchase quality coverage at a fair and
affordable price.
3.
Health insurance industry discrimination against
people with preexisting conditions violates
fundamental rights
4.
Every American should have the opportunity to
change jobs or start a small business without
losing health insurance.
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The Affordable Care Act
The new national health care law, achieves
these principles
--Passed March 23, 2010
--Reforms Come in 2 Stages
But first, we’re talking about this
because…
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The Affordable Care Act is based on the fair proposition
that when health care is made affordable people should
be personally responsible for getting coverage, rather
than shifting costs onto the rest of us. Now that the
majority of the Supreme Court has ruled the law
constitutional, it is time to move forward and get down to
the task of making quality health care affordable for4
everyone.
Stages of Reform
Stage 1 (in effect now)
• Outlaws some of the worst insurance
abuses
• Requires accountability from insurance
companies
Stage 2 (goes into effect 2014
• Guarantees every American has a place to
go to get quality affordable health coverage
• Permanently outlaws health insurance
industry discrimination
• Requires Members of Congress to buy the
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same plans offered to us.
Stage 1 Reforms
Insurance Practices Outlawed now under
the Affordable Care Act
• Preexisting condition exclusions (kids
now/everyone in 2014)
• Lifetime limits
• Using loopholes & fine print to deny claims
• Dropping coverage after a person gets sick
• Excessive insurance industry profits and
overhead (80-85% of your premium dollars
must be spent on medical care, not profits)
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Stage 1 Reforms
The Affordable Care Act guarantees
• Preventive care coverage & screenings
with no co-pays or deductibles
• Young adults can stay on parents policies
until age 26
• Preventive care without cost sharing for
seniors on Medicare
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The Faces of Reform
How the Affordable Care Act is
already helping people
across Wisconsin who would
otherwise be the victims of
health insurance
discrimination
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Sami’s Story
“My 7-year-old son, Sami, suffers from a
disease that causes tumors to grow all
over his body. Sami’s treatments could
not continue if we hit our insurance
policy’s life time limit. Thanks to the
Affordable Care Act, insurance
companies can no longer impose
lifetime limits or deny health coverage
to children like Sami with preexisting
conditions. We can’t go back to being
on our own against the insurance
companies.”
--Tracy, Appleton,
Wisconsin
.
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Stage 2: Guaranteed Affordable
Health Care (2014)
They can never take away!
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The Affordable Care Act Ends
Discrimination for 1.3 Million
Wisconsinites Under 65
• More than 1.3 million
Wisconsinites under the age of
65 have been diagnosed with
pre-existing conditions that,
without health reform, could
lead to denials of coverage or
discriminatory rates.
• As we age, the risk of
insurance industry
discrimination escalates.
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Just Some of the Examples of
Preexisting Conditions
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Competitive Health
Marketplace for Middle Class
• Open to all Americans who don’t have affordable
health coverage options now or in the future.
• Created by each state, or federal government if state
refuses
• You choose your own private insurance on a website,
like Travelocity or Consumer Reports.
• Consumers in control, with clear information and real
competition.
• Members of Congress offered same choices we
have.
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Competitive Health
Marketplace for Middle Class
• Makes coverage more secure: bans
denials of coverage due to preexisting
conditions or dropping coverage when
someone get sick.
• Makes coverage more affordable:
generous premium tax credits on a sliding
scale.
• Creates new options, such as a nonprofit
member owned health insurance
cooperative.
• Bans discriminatory pricing based on
medical condition, age, or gender.
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Gender Discrimination
• In one of the most glaring inequities, women
are charged more then men by health
insurers.
• This and other kinds of discrimination are
outlawed in the new competitive health
marketplace.
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Gurantees BadgerCare to low
income Wisconsinites
• No more loopholes, complicated eligibility
requirements, waiting lists: everyone
below the income line gets BadgerCare.
• Medicaid (BadgerCare) expansion paid for
by the Feds, so Wisconsin saves billions.
• HOWEVER: The Supreme Court gave
states the right to reject the additional
federal money for Medicaid (BadgerCare).
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Strengthen Medicare
The Affordable Care Act protects Medicare
benefits and strengthens the program for
future generations by
• cracking down on waste, fraud, and abuse in
Medicare,
• ending handouts to insurance companies, and
• providing free preventive care to decrease
costly emergency room visits and reduce
health care costs long-term.
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Remy’s Story
“I own a small café. Over 20 years ago I
beat cancer, but ever since then no
insurance company would sell me a
policy because my cancer is called a
preexisting condition. Starting in 2014
under the Affordable Care Act, no
insurance company will be allowed to
discriminate against me because I’m a
cancer survivor.”
--Remy, Pepin, Wisconsin
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Steve’s Story
"I suffered from a deteriorating spine
problem for about 10 years...We
discovered what so many Americans
have had the misfortune of
discovering-It was impossible to
purchase health insurance on the free
market if you were considered high risk
(had a pre-existing condition)...We
applied many times over the years to
every health insurance company we
could find and were flat out
rejected…with little other option I took
a 20 hour flight to Malaysia to get
treatment. Under the Affordable Care
Act, I will have a right to coverage so I
can get treatment here in the U.S.”
--Steve, Verona, Wisconsin 19
The Choice
• There are only two serious approaches to
health care on the table:
• Option 1: Continue to implement the
Affordable Care Act, which is already
protecting us and will guarantee greater
security and freedom.
• Option 2: Repeal ACA, and allow
insurance companies to control our health
care options: enabling them to continue to
jack up premiums and profit by preexisting condition and gender
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discrimination.
The Affordable Care Act is
Worth Protecting
Insurance companies must now play fairly.
It’s the law.
•
PROTECTION: Working families no longer can be denied coverage
for preexisting conditions, risk losing their coverage when they get
sick or hit a “lifetime limit”
•
PREVENTION: Preventative care must be covered free of charge by
insurance companies--including mammograms for women and
wellness visits for seniors.
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The Affordable Care Act is
Worth Protecting
Insurance companies must now play fairly.
It’s the law.
•
•
FAIRNESS: Millions of Americans will receive a rebate because their
insurance company spent too much of their premium on
administrative costs or CEO bonuses.
PEACE OF MIND: Families will not be forced into bankruptcy when
someone gets sick, and can get affordable coverage no matter where
they choose to work or what gender they are; with no loopholes or
fine print in your policy!
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The Affordable Care Act is
Worth Protecting
Insurance companies must now play fairly.
It’s the law.
•
PROTECTION: Working families no longer can be denied coverage
for preexisting conditions, risk lose their coverage when they get sick
or hit a “lifetime limit”
•
PREVENTION: Preventive care must be covered free of charge by
insurance companies--including mammograms for women and
wellness visits for seniors.
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Questions?
• Kevin Kane
Healthcare Organizer
Citizen Action of Wisconsin
414 550 8280 (cell)
kevin.kane@citizenactionwi.org
facebook.com/got.healthcare
GotHealthcareWI.com
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