1. Patient Protection and Affordable Care Act Aaron, Rochelle, Hannah, and Megan

2. Medicare The act would give out a $250 rebate to those who fall in the Medicare Part D “Donut Hole” The act would also reduce the coinsurance rate (amount you have to pay) from 100% to 25% by 2020 *make pharmaceutical companies provide a 50% discount for brand name drugs for people inside the donut hole and provide government subsidies for generic drugs for individuals in the donut hole Obamacare also looks to make enrolling in catastrophic coverage cheaper between 2014-2019

3. Medicare (cont) The act makes the amount of money a dual eligible (eligible for both medicare and medicaid) person pays out of pocket (or cost sharing) the same for dual eligible people that receive service in an institution or who have home/community based service.Expands medicare to people that have been subject to environmental hazards Pays doctors that practice where there are less doctors more Pay hospitals in counties with lowest medicare spending Stops Medicare Advantage plans from charging higher cost-sharing for some medicare benefits

4. Improving the Workforce: Innovations Hannah The Act works to establish a multi-stakeholder Workforce Advisory Committee to develop a national workforce strategy. “Multi-stakeholder”: governance structure that seeks to bring stakeholders together to participate in the dialogue, decision making, and implementation of solutions to common problems or goals. Goal of the Commission: is to provide complete, unbiased information to Congress and the Administration about how to align Federal health care workforce resources with national needs.

5. Improving the Workforce: Increasing Supply of the Healthcare Workforce Hannah -Federally supported student loan funds-easier to qualify for loans -Nursing student loan program-increases loan amounts and can have loans longer for nurses -Healthcare workforce loan repayment programs-loan repayment program for pediatric subspecialists(work in health professional shortage area, medically underserved area, or with a medically underserved population) -Grants for States and local programs-Awards scholarships to mid-career public and allied health professionals -Nurse-managed health clinics-creating a $50 million grant program administered by HRSA to support nurse-managed health clinics.

6. Enhancing Health Care Workforce Education and Training Hannah -Training opportunities for direct care workers: Authorizes funding over three years to establish new training opportunities for direct care workers providing long-term care services and supports. -Mental and behavioral health education and training grants: Awards grants to schools for the development, expansion, or enhancement of training programs in this area. -Nurse faculty loan program: Established a federally-funded student loan repayment program for nurses with outstanding debt who pursued careers in nurse education. -Grants to promote the community health workforce: grants to promote positive health behaviors

7. Supporting the Existing Healthcare Workforce Hannah Centers of excellence: enhance recruitment, training, academic performance and other supports for minorities interested in careers in health Workforce diversity grants: Expands the allowable uses of nursing diversity grants to include completion of associate degrees Primary Care Extension Program: educate and provide technical assistance to primary care providers about evidence-based therapies, preventive medicine, health promotion, chronic disease management, and mental health.

8. Strengthening Primary Care and Other Workforce Improvements Hannah -Expanding access to primary care services and general surgery: provides primary care practitioners, as well as general surgeons practicing in health professional shortage areas, with a 10% Medicare payment bonus for five years. Distribution of additional residency programs: special preference is given to programs in States with physician shortage. -Grants to increase teaching capacity

9. Developments++: Workforce -Expanded nursing programs -Distributed the healthcare industry in areas where it was needed -Grants to nursing schools: more scholarships available

10. Community Health Centers Increases funding for FQHCs and the NHSC Uses grant money to give funds How much grant money was given? Grant money to expand Health Centers/Medical Services Arguments: Not everyone got grant money Megan http://trib.com/news/local/casper/obamacare -money-will-extend-hours-at-casper-health- center/article_3eb05e90-3163-5da1-ad4d- b97c1d040209.html

11. School-based Health Centers What are SBHCs? Funding under The Affordable Care Act What is the funding for? Megan http://www.christianhealth.org/school- based-health-centers/

12. Trauma Care In order to strengthen emergencies departments, new trauma center programs will be established The Affordable Care Act reauthorized both Trauma Care Systems Planning and Development (TCSP) and the National Trauma Center Stabilization (NTCS) Acts (Sangji). Rochelle

13. Problems with Trauma Care Although the Affordable Care Act has been passed, there are still some problems that discourage any improvement to its running Legislatures who want to repeal ObamaCare are unwilling to allocate funds to programs such as the TCSP and NTCS Without these funds, the programs are not able to do what they were set up to do-to research, implement, and evaluate models for emergency care Rochelle

14. Problems with Trauma Care Some critics claim that ObamaCare didn’t confront the real issues with trauma care (Waters). Lack of access to facilities Lack of access to doctors Misuse of the ER

15. Public Health and Disaster Preparedness https://dcp.psc.gov/osg/pharmacy/documents/reserve.pdf The Ready Reserve Corps was created by Obamacare This is what most people, who are under informed about Obamacare, think that the RRC is Obama’s private army. Megan http://www.mooc.com/ disaster- preparedness-for-the- health-care- professional/

16. Requirements for Non-profit Hospitals Under the Affordable Care Act, new requirements have been imposed for charitable hospitals (“Nonprofit Hospital Requirements”). Under the act, they must meet four generalized requirements: establish written financial assistance and emergency medical care policies put caps on emergency and medical care for people on the hospital’s assistance policy determine if individuals are eligible for assistance under the hospital’s assistance policy before enforcing actions of collection on the patient every 3 years, adopt and implement a strategy for community health needs (CHNA). Rochelle

18. Criticisms for Nonprofit Hospitals under ACA $50,000 fine for not following the new regulation requirements There is also some concern about whether or not the hospital will have to make their plans publicly available Rochelle

19. American Indians Reauthorize the Indian Health Care Improvement Act (IHCIA) Indians have a different relationship with the government Patient Protection and Affordable Care Act only affects Tribes in “critical events” Megan http://usatoday30.usatoday.com/ne ws/health/2010-04-22-native- american-doctors_N.htm

20. IHCIA under ObamaCare Reinstated the IHCIA that expired in 2000 This was a positive thing for the Tribes What did reinstating the IHCIA do? Megan http://www.americancla.org/abortion _and_life_112th.html

21. Resources Altman, Drew E., Ph.D. "Health Reform Implementation Timeline." Health Reform Implementation Timeline. Henry J. Kaiser Family Foundation, Aug. 2014. Web. 07 Jan. 2016. Anderson, Amy. "The Impact of the Affordable Care Act on the Health Care Workforce." The Heritage Foundation. N.p., n.d. Web. 11 Jan. 2016. "The ACA and the School-Based Health Center Capital Program." HHS.gov. Assistant Secretary for Public Affairs, 08 Dec. 2011. Web. 07 Jan. 2016. Hoss, Aila, JD. "American Indian and Alaska Native Mental Health Research." (n.d.): n. pag. Public Health Law Program, 15 Jan. 2015. Web. 8 Jan. 2016. Sangji, Naveen F., MD. "Trauma and Emergency Care under the Affordable Care Act | The Bulletin." The Bulletin. American College of Surgeons, 31 Mar. 2014. Web. 07 Jan. 2016. "Summary of Provisions in The Patient Protection and Affordable Care Act." Obamacare Facts. HealthNetwork, n.d. Web. 11 Jan. 2016. Waters, JIm. "Obamacare Induces Emergency Room Trauma." The American Spectator. The American Spectator Foundation, 26 May 2015. Web. 11 Jan. 2016. Cooper, Jennifer. "Indian Health Care Improvement Act." National Indian Health Board. N.p., 14 May 2010. Web. 08 Jan. 2016. "Indian Health Service The Federal Health Program for American Indians and Alaska Natives." Indian Health Care Improvement Act Made Permanent. Indian Health Service, 27 Mar. 2010. Web. 11 Jan. 2016. "Nonprofit Hospital Requirements | Independent Sector." Nonprofit Hospital Requirements | Independent Sector. Independent Sector, n.d. Web. 11 Jan. 2016.