It's been a while since I've sat in on a class, but taking notes made me feel like a kid again! Today I provide you with highlights on a Kaiser Family Foundation Obamacare seminar so you know the bare necessities of healthcare reform in a simple, bullet-pointed format. The goal: to explain Obamacare (Affordable Care Act) so a 12-year-old can understand. Call it Obamacare 101!
Problems: (Healthcare Prior to Obamacare)
- Health insurance is expensive.
- The average family premium cost $14,000/year. Premiums have doubled over the past few years.
- More people are aging, meaning more people have health problems.
- Healthcare costs are the fastest growing part of the federal budget.
2. The system is full of holes.
- People can be turned down for health insurance if they’re sick.
- Some small companies are charged extra if some workers are sick.
- Some insurance plans have a lifetime limit on benefits.
- Some least likely to have coverage need it the most.
- Insurers will be limited on how they spend on premium dollars. If they use too much for administrative costs for profits, they must give back money in rebates to customers.
- Preventive healthcare services will be free: screenings, vaccinations, etc.
- Seniors will get more rebates to pay for their drugs.
- Young people can stay on parents’ policy until age 26.
- Small businesses will get tax breaks to help pay for health insurance for workers.
- Lifetime limit will be gone.
- It's illegal to turn down children with preexisting conditions.
- There will be a High Risk Pool to cover those with preexisting conditions between now and January 1st 2014. It’s risky for health insurers to cover these people so the government will pitch in to keep costs low.
Janurary 1st, 2014
(When Obamacare's Biggest Changes Kick In)
- Medicaid will be expanded to cover all low income families and individuals in every state.
- If you lose your job/employer doesn’t provide decent coverage, you may get a health insurance tax credit.
- If you don’t have health insurance offered to you by an employer, you can shop in the Exchange.*
- Insurers can’t charge more or deny you coverage if you’re sick. (Why not wait until I’m sick?) Individuals will be mandated to buy coverage or pay a fine. Larger businesses will also pay a fine if they don’t cover workers.
- By 2019, 32 million Americans will have health insurance who didn’t before. 23 million people will still be uninsured: those are undocumented immigrants who aren’t eligible for coverage.
Exchanges: Virtual Shopping Malls For Health Insurance
Based on where you live, you get a menu of options to shop for health insurance.The idea is to provide good information, level the playing field, and provide lots of choices to keep rates competitive amongst insurance companies who want your business.
How To Pay For This: Health Care Reform will cost $938 billion over next 10 years.
- That $928 billion in healthcare reform costs will be 2% of federal budget and 3% of what will be spent on healthcare overall.
- Fees government pays to hospitals under Medicare won’t be allowed to rise as fast as they have been.
- Insurance companies who provide services for people on Medicare will be paid less.
- Federal advisory board will deal with increase on healthcare costs.
- Experiments to test different ways to pay doctors and hospitals to increase quality of care will take place.
- People with high earnings will pay higher Medicare taxes.
- Taxes to insurers who provide high-end benefit plans.
- Taxes on companies who make medical devices and drugs.
- Taxes on people who go to tanning salons.
- Savings will reduce federal deficit. (Savings estimated to be $124 billion over the next 10 years.)
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