![[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Health Care Reform 2010](https://image.slidesharecdn.com/hcjcjuly-100804143535-phpapp02/85/hcjc-july-1-320.jpg)
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- 2. Health care reform means better coverage you can count on throughout your entire life.
- 3. Health care benefits for children…
- 6. No more denying coverage to children with pre-existing conditions. Health care benefits for children…
- 7. Health care benefits for young adults…
- 8. Health care benefits for young adults…
- 13. Young adults are more likely to work for a small business than any other population. Health care benefits for young adults…
- 15. Beyond prenatal…beyond childhood… beyond young adult…to families
- 17. Health care benefits for seniors
- 19. Better coverage throughout the stages of my life but how will all of this work?
- 22. What we have to look forward to…
- 23. What we get now…
- 24. END TO…
- 25. What’s left to be done? What are the next steps? INFORM – IMPLEMENT - IMPROVE
- 26. What’s left to be done? What are the next steps? INFORM – IMPLEMENT - IMPROVE
- 27. What’s left to be done? What are the next steps? INFORM – IMPLEMENT - IMPROVE
- 28. About HCJC … and hundreds more local organizations, businesses, affiliates, and supporters.
Hinweis der Redaktion
- Reasonable Break Time for Nursing Mothers – Amends the Fair labor Standards act of 1938 to require that employers provide a reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s birth, and provide a place, other than a bathroom, that is shielded from view and free from intrusion of coworkers and the public Support, Education and Research for Postpartum Depression – Bobby Rush’s issue, amends Title V to provide 3 million in new grants to states in 2010 to provide services to individuals with, or at risk of, postpartum depression and their families Pregnancy Assistance Fund – Authorizes and appropriates $25 million annually for ten years to a new pregnancy assistance fund which will be given out in a competitive grant program to states to help pregnant and parenting teens and women, grantees would be required to establish programs with providers to meet the specified needs of these women
- ONCE AND FOR ALL, INSURANCE COMPANIES WILL NO LONGER BE ABLE TO DENY COVERAGE TO CHILDREN WITH PRE-EXISTING CONDITIONS!
- 1 in 6 young adults have a common chronic condition 1 in 6 young adults end up in the ER due to an injury- the highest among any age group 1 in 3 young adults graduate with school debt, making any medical debt an additional financial burden 1 in 4 young adults reported medical debt
- What’s the Issue: Young adults that are transitioning from school to the job world are often left without health coverage. Most job-based policies require that the student be in school full-time in order to stay on their parents’ plan and most limit eligibility for coverage to age 21 or 23. Young adults are one of the largest segments of the uninsured—45 percent of young adults between the ages of 19 and 29 went without health insurance at some point during 2009. In addition, the current economic situation makes it even harder for those just out of school to find jobs, leaving them without a reliable source of coverage. Possible Direction: Give a scenario of a recent college grad trying to get a job in the current market. It’s incredibly difficult. If they are taken off of their parents’ coverage at 21, they will be without coverage unless they can afford to buy their own. And, due to the economy, many employers are only offering work on a contract basis, and contract employees generally aren’t offered insurance. So, if they get sick or hurt, they may have to go to the emergency room for care, which can cost thousands of dollars out of pocket. What Health Reform Will Do: All young adults will be able to stay on their parents’ or guardians’ plan through the age of 26. What’s the Issue: Young adults that are transitioning from school to the job world are often left without health coverage. Most job-based policies require that the student be in school full-time in order to stay on their parents’ plan and most limit eligibility for coverage to age 21 or 23. Young adults are one of the largest segments of the uninsured—45 percent of young adults between the ages of 19 and 29 went without health insurance at some point during 2009. In addition, the current economic situation makes it even harder for those just out of school to find jobs, leaving them without a reliable source of coverage. Possible Direction: Give a scenario of a recent college grad trying to get a job in the current market. It’s incredibly difficult. If they are taken off of their parents’ coverage at 21, they will be without coverage unless they can afford to buy their own. And, due to the economy, many employers are only offering work on a contract basis, and contract employees generally aren’t offered insurance. So, if they get sick or hurt, they may have to go to the emergency room for care, which can cost thousands of dollars out of pocket. What Health Reform Will Do: All young adults will be able to stay on their parents’ or guardians’ plan through the age of 26.
- By Executive Order, the Hyde Amendment will apply to all provisions of health reform. The HA prohibits any federal funding from being used to purchase an abortion except in cases of rape, incest or endangering the life of the mother. This currently includes Medicaid, plans participating in Federal Employees Health Benefit Plans and members of the military. For individuals purchasing coverage on the exchange and who receive federal subsidies, they will need to send two separate payments to insurance provider, to ensure that no federal funds were being used in the transaction. Sex ed: $75M/year through FY2014 for Personal Responsibility Education grants to states for programs to educate teens on both abstinence and contraception for prevention of teen pregnancies and STIs Funding also for: Innovative teen pregnancy prevention strategies and services to high-risk, vulnerable and culturally under-represented populations. Research and evaluation, training and TA. To Indian tribes and tribal organizations. Allocates $50M/year through FY2014 for abstinence only education – note that while at least a dozen other states have rejected this funding b/c studies have not shown their effectiveness, IL still continues to accept this funding Reproductive health Prescription drugs, maternity and newborn care, included in basic coverage Access to OB/GYN care will be direct and not necessary to get a referral from PCP Allocates funds for state grants to promote community health teams that provide support patient-centered medical home. These community-based, interdisciplinary teams will provide support services to primary care practices, including OB/GYN practices. Creates new pregnancy assistance fund that establishes a competitive grant program for states to establish programs for specific needs of pregnant and parenting teens and women. Sources: PP, NWLC, Guttmacher
- Expanding the health care workforce allows more opportunities for young adults and those interested in going into the medical field.
- Expanding the health care workforce allows more opportunities for young adults and those interested in going into the medical field.
- Among young working adults in firms of fewer than 50 employees and who had coverage in 2006, one in four lost that insurance in the following two years- more than twice the rate of older adults Young adults working in small businesses are not only less likely to get insurance, but they are also more like to lose that insurance by their employer over time. To provide support for small businesses means supporting our working young adults…
- The law will expand Medicaid to include low-income childless adults who have been excluded from Medicaid in 43 states, including Illinois. Now all adults under the age of 65 with household incomes up to 133% FPL will be eligible for Medicaid. And they will be guaranteed an essential health benefits package. Initially, the federal government will fully finance the cost for “newly-eligible” Medicaid beneficiaries. After 2016 the matching rate will begin to be reduced gradually and will level out at 90% in 2020 and for future years – still well above the current matching rate. The enhanced match is limited to people who were not eligible for Medicaid as of December 1, 2009. This change goes into effect in 2014, but states do have the option to enroll these persons sooner. Illinois has not made a decision yet as to whether they will implement this option sooner than 2014. In Illinois, this means that 600-700,000 new people will be eligible for Medicaid There are 17.1 million uninsured adults with incomes below 133% fpl and close to half (47% of uninsured adults have incomes below 133% fpl) What’s the Issue: Out-of-pocket costs can send people into medical debt. In 2009, an estimated 14.3 million Americans with insurance were in families that spent more than 25 percent of their income on health care. Nearly two-thirds of bankruptcies are due, at least in part, to medical causes. What Health Reform Will Do: The amount that anyone will pay each year out-of-pocket for health expenses will be capped. Lower- and moderate-income families will receive extra assistance to help them pay their out-of-pocket costs. Consumers will have health security and peace of mind knowing that it will be much harder for them to fall into debt due to their medical costs.
- $250 rebate in 2010 for individuals who fall into the doughnut hole. This will increase annually. Reduces Medicare’s spending on uncompensated care by expanding the number of Americans who have insurance Expanded role of Community Health Centers to implement wellness programs for Medicare beneficiaries . Federal funds will reimburse employers or insurers for 80% of retiree health claims. People with Long-Term Care Needs will be able to get more services to help them live independently at home and in their community. If you are working you can participate in a voluntary insurance program that will later help you pay for some of your future long-term care services and supports. You may have heard it called the CLASS Act [CLASS stands for C ommunity L iving A ssistance S ervices and S upports] This new program will pay you a lifetime cash benefit if you have a qualifying disabled that limits your day-to-day living You have to pay premiums into the program for at least five years. If your employer participates in the program, you will automatically be enrolled as early as January 2011 . You will pay premiums through a payroll deduction unless you choose not to participate in the insurance, meaning you “opt out.” You will also be able to purchase the insurance if your employer doesn’t participate in the program or if you are self-employed. Daily cash benefit (about $50 minimum), no medical underwriting, ages 18+, earn enough to qualify for a quarter of Social Security ($1,100 in 2010) Premiums will vary by age, CBO estimates an average monthly premium of $123 Must pay premiums for at least 5 years to qualify for benefit, work at least 3 of the first 5 years enrolled, have a functional limitation (2-3 ADLs) States will get added financial support for home and community-based services that are so important to seniors who want to remain independent and in their own homes as they age. Medicare will enhance its Nursing Home Compare tool You’ll have ready access to A standard complaint form Resident rights and consumer information Links to State survey reports Links to summaries of complaints against the facilities. This information will help you make more informed decisions when selecting a nursing home.
- Create state-based insurance exchanges called the American Health Benefit Exchanges and Small Businesses Health Options Programs Exchange open to small businesses with fewer than 100 employees. Exchanges open in 2014. Federal support also offered for nonprofit member-run insurance cooperatives All families will choose their insurance plan from one of the options listed on the new Exchange. Think of it like “Expedia” for insurance plans. Starting in 2014, in one location, using one application, all insurance plans, including Medicaid, will be presented in a clear, user-friendly format that allows consumers to understand plan terms and compare benefits and services across plans. And it will be provided in plain, common sense language. Insurers will offer four levels of coverage that vary based on premiums, out-of-pocket costs, and benefits plus a catastrophic coverage plan. All health plans in the Exchange must offer a standard set of comprehensive benefits including medical, mental health, prescription drug and rehabilitative services. To access the Exchange families will provide their family and income information and their preferences for type of plan and benefits, and then the Exchange will show them the different plans and benefits that meet that criteria. They will also be able to view whether they qualify for Medicaid or a premium subsidy. Health plans participating in the Exchange are required to have enough doctors to cover their patients, contract with essential community providers, perform well on quality measures, and use a standardized enrollment form and format to present plan information. The Exchanges will be state-based; it will have a customer service call center. Access to coverage through the Exchange is restricted to U.S. citizens and legal immigrants who are not incarcerated. Small businesses with up to 100 employees can purchase coverage through the Exchange. Businesses with more than 100 employees are eligible after 2017 Families purchasing insurance on the Exchange also benefit from free screenings, immunizations and vaccines. So those are the three main provisions that the new law provides to help cover an additional 32 million people. For people who currently have insurance through their employer, they can keep it. Existing employer-sponsored insurance plans will remain essentially the same, except that the insurers will now have to abide by the new consumer protections that we are going to talk about later. So we have looked at where and how families will get their insurance coverage. What’s the Issue: Current regulation of insurance markets is run by a hodgepodge of state and federal rules. There is little standardization of the information that insurers must provide, making it difficult for consumers to understand exactly what is and is not covered and to compare other aspects of insurance plans. A handful of insurance companies operate a near-monopoly of the insurance market. What Health Reform Will Do: A new, regulated marketplace will be created to promote competition among insurers and to give consumers the opportunity to purchase the best plan at the best price. Every American will have the same kinds of choices of coverage that Congress has and eventually, members of Congress will purchase their coverage through the same places that the uninsured and small businesses do. Possible Direction: Talk about how the Federal Employee’s Health Benefit Plan (Congress’s health care) works, i.e., they get their health insurance through an exchange. All insurers will be required to present health plan information in a clear, user-friendly format that allows consumers to understand plan terms and compare benefits and services across plans. Health plan information will be standardized, which will promote competition as consumers shop for the best plan. Possible Direction: Talk about other forms of information standardization, such as nutrition labels. They allow consumers to compare various nutritional aspects of the food product, like number of calories and percentage of daily value of calcium, etc., that help consumers make healthy choices. Only legal U.S. citizens able to purchase in exchanges. What’s the Issue: Current regulation of insurance markets is run by a hodgepodge of state and federal rules. There is little standardization of the information that insurers must provide, making it difficult for consumers to understand exactly what is and is not covered and to compare other aspects of insurance plans. A handful of insurance companies operate a near-monopoly of the insurance market. What Health Reform Will Do: A new, regulated marketplace will be created to promote competition among insurers and to give consumers the opportunity to purchase the best plan at the best price. Every American will have the same kinds of choices of coverage that Congress has and eventually, members of Congress will purchase their coverage through the same places that the uninsured and small businesses do. Possible Direction: Talk about how the Federal Employee’s Health Benefit Plan (Congress’s health care) works, i.e., they get their health insurance through an exchange. All insurers will be required to present health plan information in a clear, user-friendly format that allows consumers to understand plan terms and compare benefits and services across plans. Health plan information will be standardized, which will promote competition as consumers shop for the best plan. Possible Direction: Talk about other forms of information standardization, such as nutrition labels. They allow consumers to compare various nutritional aspects of the food product, like number of calories and percentage of daily value of calcium, etc., that help consumers make healthy choices.
- The health care justice campaign, known as HCJC, is…