The Affordable Care ActMaking health care more secure and

returning control to consumers

1

Before the Affordable Care

Act

It was legal for health insurance Companies to

DENY COVERAGE

to kids with cancer and other pre-existing

conditions.

We must never go back!

DeniedPre-existing

condition

We must move forward!

Starting in 2014

It will be illegal for health insurance

companies to

DENY COVERAGE

to people with cancer and to cancer

survivors

Starting in 2014

It will be illegal for health insurance Companies to

DENY COVERAGE orCHARGE HIGHER RATES

to all people with pre-existing conditions

We must move forward!

Freedom:

• Every American should have the freedom to control their own medical decisions without interference from insurance companies.

Access to Health Care is anAmerican Value

Access to Health Care is anAmerican Value

Opportunity:

• Americans who lack access to stable and affordable health coverage do not have a fair shot at the American dream.  They face a constant threat of having their lives and careers devastated by health disasters that also become financial disasters.

• Every American should have the opportunity to change jobs or start a small business without losing health coverage.

Access to Health Care is anAmerican Value

Responsibility:

• Everyone should take responsibility for getting health care coverage for themselves and their families so long as it is made affordable and accessible.

• The insurance industry should be able to make reasonable profit but in return should be held accountable by not profiting from abusive practices and discrimination.

The Affordable Care Act

The national health care lawadvances American health care values

--Passed March 23, 2010

--Reforms Come in 2 Stages

But first, we’re talking about this because…

It’s the law of the land and it’s time to move forward. The private market failed to guarantee

access to affordable health coverage. For the first time everyone will have somewhere to go to get good coverage at a reasonable price, no matter

what.

Stages of Reform

Affordable Care Act signed into law

Stage 1 Early Reforms

The Affordable Care Act holds insurance industry and government responsible for:

• Preventive care coverage & screenings with no co-pays or deductibles

• Young adults can stay on parents private insurance policies until age 26

• Preventive care without cost sharing for seniors on Medicare

Because of healthcare reform

over 6 million young adults are now covered on their parents’

policy.

Stage 1 Early Reforms

Insurance industry violations of health care freedom already outlawed by the Affordable Care Act

• Preexisting condition exclusions (kids now/everyone in 2014)

• Lifetime limits

• Dropping coverage after a person gets sick

• Excessive insurance industry profits and overhead capped

Pre-existing Condition

“Profiling” Will Be Outlawed

Sami’s Story“My 7-year-old son, Sami, suffers

from a disease that causes tumors to grow all over his body. Sami’s treatments could not continue if we hit our insurance policy’s life time limit. Thanks to the Affordable Care Act, insurance companies can no longer impose lifetime limits or deny health coverage to children like Sami with preexisting conditions. We can’t go back to being on our own against the insurance companies.”

--Tracy, Appleton, Wisconsin.

The Affordable Care Act ends health insurance industry assault

on opportunity and freedom of 1.3 million Wisconsinites

• More than 1.3 million Wisconsinites under the age of 65 have been diagnosed with pre-existing conditions that, without health reform, could lead to denials of coverage or discriminatory rates.

• As we age, the risk of insurance industry discrimination escalates.

Just Some of the Examples of Preexisting Conditions

Gender Discrimination

Stage 2 Full Reform:

Guaranteed affordablehealth care (2014) that

can never be taken away!

Health coverage guaranteed to everyone who buys insurance on their own or works for a small business through new consumer-friendly competitive marketplaces

Competitive Health Marketplace for Middle

Class

• Created by each state, or federal government if state refuses (Wisconsin refused)

• You choose your own private insurance on a website, like Travelocity or Consumer Reports.

• Consumers in control, with clear information and real competition.

• Members of Congress offered same choices we

have.

• Open to all Americans who don’t have affordable health coverage options now or in the future.

Competitive Health Marketplace for

Middle Class

• Coverage more secure: bans denials of coverage due to preexisting conditions or dropping coverage when someone get sick.

• Coverage more affordable: premium tax credits on a sliding scale.

• New options, such as nonprofit member owned cooperatives.

• No discriminatory pricing based on medical condition, age, and gender.

Remy’s Story“I own a small café. Over 20 years

ago I beat cancer, but ever since then no insurance company would sell me a policy because my cancer is called a preexisting condition. Starting in 2014 under the Affordable Care Act, no insurance company will be allowed to discriminate against me because I’m a cancer survivor.”

--Remy, Pepin, Wisconsin

BadgerCare for low income Wisconsinites

• The Affordable Care Act gives billions in federal dollars to WI to fill in the holes in BadgerCare.

• HOWEVER: The Supreme Court gave states the ability to reject this additional federal money.

• Governor Walker rejected the federal funds.

• Walker’s approach costs Wisconsin $149 million more in the current state budget and forces 98,000 off BadgerCare.

• The good news is that because of the Affordable Care Act people forced off of BadgerCare will have access to the new health insurance marketplaces.

• The bad news is that it will be hard for very low income people to afford because the law assumed that this group would end up on BadgerCare.

• The additional good news is that Wisconsin can take the enhanced BadgerCare money at any time.

• This will happen, the only question is how long people have to go without health coverage.

Before You Assume This is A Partisan

Issue…

• Chris Christie, New Jersey, (R)

• Jan Brewer, Arizona, (R)

• Rick Scott, Florida, (R)

• Terry Branstad, Iowa (R)

• Rick Snyder, Michigan, (R)

• Brian Sandoval, Nevada, (R)

• Susana Martinez, New Mexico, (R)

• Jack Dalrymple, North Dakota, (R)

• John Kasich, Ohio, (R)

• Lincoln Chaffee, Rhode Island, (I)

Conservative Governors Who Have Accepted Federal Funds

Terry’s Story"I'm a personal care worker, I work at a

group home and makes $9 an hour taking care of people's health. Even though I work to keep other people healthy, I do not have affordable health care myself. I have not been able to qualify for BadgerCare, in fact I'm just over number 141,000 on the waiting list. I'm father of three, I want to give my children their chance at the American dream but without health insurance, we're looking at an uncertain future."

-Terry O, Milwaukee

Strengthen Medicare

The Affordable Care Act protects Medicare benefits and strengthens the program for future generations by:

• cracking down on waste, fraud, and abuse in Medicare,

• ending handouts to insurance companies, and

• providing free preventive care to decrease costly emergency room visits and reduce health care costs long-term.

Why Is This Even An Issue?

• Big Insurance wants to repeal health reform so it can continue to profit from discrimination.

• Some unscrupulous politicians want to sabotage the implementation of health reform in order to further their political ambitions.

•There are ideological opponents who refuse to accept health reform and cannot be swayed by any amount of facts showing the benefits.

The Affordable Care Act is Worth Protecting

Insurance companies must now play fairly.

It’s the law.

• PROTECTION: Working families no longer can be denied coverage for preexisting conditions, risk losing their coverage

when they get sick or hit a “lifetime limit”

• PREVENTION: Preventative care must be covered free of charge by insurance companies--including mammograms for

women and wellness visits for seniors.

The Affordable Care Act is Worth Protecting

Insurance companies must now play fairly.

It’s the law.

• FAIRNESS: Millions of Americans have received a rebate because their insurance company spent too much of their

premium on administrative costs or CEO bonuses.

• PEACE OF MIND: Families will not be forced into bankruptcy when someone gets sick, and can get affordable coverage no matter where they choose to work or what gender they

are; with no loopholes or fine print in their policy!

Questions?

• Kevin Kane

Healthcare Organizer

Citizen Action of Wisconsin

414 550 8280 (cell)

kevin.kane@citizenactionwi.org

facebook.com/got.healthcare

GotHealthcareWI.com