Transcript Active conservative groups - University of Wisconsin–Madison

Health Reform and Young Adults
What do you need to know?
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Raising Women’s Voices
Fall 2010
Why did we need
national health care reform?
• Too many people have
no health insurance
coverage. More than 50
million people
nationwide are
uninsured.
• People are losing
coverage,
or have gaps in their
coverage
Insurance companies run the show!
• It’s difficult to know what your policy covers
and what it doesn’t.
• There are often hidden clauses, such as $$
limits on the amount of medical care that will
be covered or refusals to cover pre-existing
conditions.
• In some states, insurers charge women more
than men.
So, what happened?
•
•
•
President Obama signed the Patient
Protection and Affordable Care Act (PPACA)
on March 23, 2010
The provisions in the health care bill will be
implemented in phases from now until 2014.
Several very important provisions go into
effect September 23, 2010
A health reform owner’s
manual for young adults
• Why is it important ?
• How does it work?
• How does the law help young adults?
• What’s in it for young women?
Why should young people care?
• As of March 2009, 18.9 million young adults
were uninsured.
• Young people do get sick.
• It’s about cost, stupid.
• We have to speak up for our right to health
care.
Young adults: What’s been going on?
• “Aging out” of our family health
insurance policies before we have
our own insurance.
• College health insurance policies
that are expensive and
inadequate.
• Being unable to find entry-level
jobs that offer health insurance,
once we graduate.
Now, we can stay on our parents’ insurance
Starting September 23, 2010:
• We can stay our parents’ health insurance until we
are 26 years old.
• We don’t need to live at home.
• We don’t need to be financially dependent on our
parents.
• We can even be married (except that a spouse is not
eligible for the coverage – just you).
• The only exception is that if you have a job where
you are offered health insurance, you can’t stay on
your parents’ policy .
What do I or my parents need to do?
• Contact the human resources department
where your parents work and let them know
you’d like to stay on your parents’ plan. Call
them NOW – you may have only a limited
amount of time to enroll.
• Contact your parents’ health insurance
provider and ask about any additional steps
you have to take.
• Deadline: Make sure to find out what the
deadline is for making this request – you may
not have too much time!
Who will pay for me to stay on my
family health insurance plan?
• Under employer plans, the employee
typically pays a share of the premium
and the employer pays the rest.
• Therefore, the bill will probably still go to
your parents.
•
•
•
•
What about those expensive, inadequate college
health plans?
Currently 96% of all college/university plans have
caps on the amount of medical care they will cover.
This means that if you have a catastrophic accident
or really serious illness, you may run out of coverage
once the medical bills hit $500,000 or $1 million.
This practice is eliminated in the new health reform
law.
BUT! It’s unclear whether the new law will apply to all
college health care plans.
We’re going to have to make sure our college health
plans follow the new law.
Getting a job with health insurance
• STARTING NOW: Small businesses (which
employ largely young adults) will receive tax
credits to help them offer insurance.
• IN 2014: Large employers will be encouraged
to offer employee coverage, or else face a
fine.
• IN 2014: If the premium you pay for coverage
through your work is too high, you may be
able to get cheaper coverage elsewhere.
What else should we know?
What’s next?
• Between now and 2014 is a really important
time for health care reform.
• States and the federal government will be
developing new regulations, processes and
even agencies to carry it out.
• In 2014, the new health reform law will go into
effect, hopefully with all the components that
it needs to be fair and accessible.
States open insurance “exchanges”
• Each state will have a
website and telephone
hotline to help
individuals and small
businesses purchase
and enroll into “qualified
health plans.
Comparing apples to apples
Provides information on each
plan in a standard format,
including:
– Monthly cost and co-pays
– Plan performance on quality
measures
– Plan ratings by quality and price
– Information on current customer
satisfaction
More low-income people will be
eligible for public coverage
• An estimated 16 million more Americans will
qualify for Medicaid coverage. Almost 8
million uninsured young people could
benefit.
• Income eligibility goes up to 133% of federal
poverty level which is $14,400 for
individuals or $29,327 for a family of four.
Moderate-income people get help to
buy coverage
• People with incomes up
to 400% of federal
poverty limit get
subsidies on a sliding
scale to help them buy
private insurance.
• That’s an income of up
to $43,000 for a single
individual.
What role will employers play?
• Employers will be encouraged to provide
coverage for their workers.
• Those who don’t will face a fine of $2,000 for
each uninsured employee who buys
coverage in the exchange using federal
subsidies.
• Small businesses up to 100 workers can
shop in the exchange and get larger tax
credits to help them afford to cover workers.
Insurance ref gets new powers
• No denials of coverage to
adults with pre-existing
conditions.
• No charging women
more than men.
• No annual limits on
coverage.
What is our personal responsibility?
• As of 2014, we must carry health insurance,
just like car insurance.
• If we don’t, we face a fine of $95 a year or 1%
of household income in 2014. This gradually
increases over time.
• Exemptions for low-income households,
financial hardship, religious objections.
What about young women in particular?
Taking effect immediately:
– Maternity coverage is mandated.
– Licensed practitioners serving
women using free-standing
birthing centers become eligible
for Medicaid reimbursement
– Requirement that employers
provide breastfeeding women with
break time and private space to
express milk.
– Women’s Health Amendment
waives co-pays for certain
preventive services.
Ambivalence about
sex-ed and contraception
• New funds for
comprehensive sex
education and
abstinence-only ed.
• No guarantee birth
control will be deemed
a “preventive service”
exempt from co-pays.
What’s not so good for women’s health?
• Continued ban on use of federal funds to pay for
abortions. Women on Medicaid will not be able to use
their government funded coverage for abortion
services (except in case of rape, incest or threat to
life).
• Community health centers cannot provide federally
subsidized abortion services
• States may ban abortion coverage in their state
exchanges.
• If abortion coverage is offered in the exchange,
federal subsidies must be segregated and not used
for that purpose.
Is health reform perfect?
• No. There’s a lot for us to work on.
• For example, immigrants are excluded from many
provisions. Undocumented immigrants can’t even
purchase health coverage in the exchanges
using their own money.
• The subsidies may not be enough to make
insurance affordable.
• The cost of health reform could be more than
expected.
How can YOU get more involved?
1. Host an education session with your local
community and organization
2. Just tell your friends and family members
what health care reform really means,
ask for more materials from us!
3. Come to RWV events and join our
mailing list!
Raising Women’s Voices is here
to keep you updated on health reform
• Visit our website at
www.raisingwomensvoices.net
• Sign up for newsletter
and alerts by contacting
[email protected]