1 WHAT IT MEANS FOR YOU? April 2012

2 Health Access is the leading voice for health care consumers in California. Founded in 1987, Health Access is the statewide health care consumer advocacy coalition advocating for quality, affordable health care for all Californians. OUR AGENDA in 2011 and beyond includes:  Preserving access to care Fighting budget cuts to deny care and coverage to Californians;  Providing consumer protections Working to protect consumers against medical debt and abusive practices by insurers, providers, and others in the health care industry; and  Expanding coverage, Implementing and Improving the ACA for California Organizing for quality, affordable coverage for all, at both the state and federal level. Health Access

3 Why is Reform Important? An estimated 49 million Americans were uninsured in 2010, 8 million in California. Californians are more likely to have to buy insurance on their own in the individual market. California and other states have made drastic cuts to public health care programs. Insurance Companies have been allowed to put profits before people – increasing premiums and denying coverage

4 What is Federal Health Reform? The Patient Protection and Affordable Care Act was signed into law by President Obama on March 23, The purpose of this law is to address the worst problems in our health care system today by: Increasing Access and Improving Affordability Enacting Insurance Regulations and Consumer Protections Controlling Costs in the health care system.

5 How Does Reform Help You? The Health Reform Bill will impact different people in different ways. There are some provisions that will help everyone, but other provisions are tailored specifically to help young people, middle class families and individuals, small businesses, people with pre-existing conditions and serious chronic illnesses, and seniors.

6 How Does Reform Help Seniors? Increased options for older Americans not yet eligible for Medicare (through the Exchange) Limits Age Rating by Insurance Companies Ends discrimination based on pre-existing conditions Medicare Improvements: Donut hole, 2010: $250 rebates, 2011: 50% discount No More Cost Sharing for Prevention and Wellness Better oversight and reduction of waste, fraud, abuse Extending Medicare solvency for 10 years

7 How Does Health Reform Help People Who Have Insurance? Nothing requires you to change your existing policy; but it will make your coverage more secure and stable by: Requiring employers to continue offering coverage or contribute to coverage through the Exchange Ensuring you can still get coverage even if your life situation changes (job change, divorce, graduation) Setting minimum standards for what benefits must be included in insurance plans Stabilizing and fixing the “individual insurance market” Bringing down overall costs to eliminate the “hidden tax” Improving Medicare and expanding Medicaid

8 How Does Health Reform Help People Who Don’t Have Insurance? Expansion of Medicaid (Medi Cal in California) Employers will be required to provide or contribute to insurance coverage Insurance Regulations prohibit discrimination against people with pre-existing conditions The Insurance Exchange will make it simple and convenient for individuals and small businesses to access affordability subsidies and tax credits The Exchange will allow participants to access quality and affordable insurance

9 What Reforms Already in Place Small business tax credits of up to 35% Rebates, beginning to close the Medicare Part D Donut Hole Ending discrimination against children with pre-existing conditions End of Rescissions Ban on lifetime and annual limits on coverage Preventive care covered (no cost sharing) Expansion of High Risk Pool Young Adults covered through parents up to age 26 Increased funding for Community Clinics

10 The Supreme Court hearing… How did we get hear? Repeal Vote House of Representatives voted to repeal the ACA Senate voted down repeal President Obama stated he would veto a repeal bill Court Challenges Dozens of courts ruled in favor of ACA, a couple ruled against the individual mandate but upheld the law and Medicaid expansion

11 Supreme Court hearing Take-ways Historic three day history hearing Aggressive questioning from conservative justices Remain confident in the constitutionality and that it will be upheld Three possible scenarios California will continue with healthcare reform regardless of the Supreme Court outcome

12 What’s Next? Advocacy is still needed in the implementation process as federal and state regulations are finalized. We have the opportunity to go beyond federal law and improve reform to better reflects our needs and values. Areas that still need to be addressed include: Rate Regulation Public Option Benefit Mandates: maternity, mental health, substance abuse (Governor signed this bill in 9/2011) Eligibility/Enrollment (Governor signed this bill in 9/2011) Populations left out of ACA

13 What Can You Do? Share your story – we need your stories in order to remind legislators and the media why this is important Call Congress – Speak Up! Share what you’ve learned with your colleagues, clients, friends and family. Stay Informed – get updates and alerts from Health Access :