OBAMACARE

PATIENT PROTECTION AND AFFORDABLE CARE ACT

UNINSURED RATES AMONG NONELDERLY BY STATE,(2009-2010)

ACA ACCOMPLISHMENTS:

• Pre-existing Condition Insurance Program (PCIP).• Young Adult Coverage: for children up to 26 years old.• $250 “Donut Hole” Rebate .• 50% Discount on Covered Drugs .• Many Preventive Care Services For cancer for Free. • Strengthening Community Health Clinics. • 85% of Insurance Premium must go to Health Care.

ACA IMPROVEMENTS• Expanding Medicaid Payments to Physicians ( although very small).

• Establishing the Marketplaces- Enrolment Oct. 2013

• Medicaid Expansion: incomes less than 133% of the poverty level (approximately $15,000 for an individual and $31,000 for a family of four)

• Tax Credits: (income between 100% and 400% of the FPL)

• Eliminates lifetime benefit limits and phases out annual limits

• No Discrimination Due to Pre-existing Condition or Gender.

• Law also forces the insurance companies to justify more than 10% in increase in premium.

EXPAND COVERAGE AND BENEFITS

• Additional rules for insurers.• Expands coverage for 32+ million people. • Makes health insurance more affordable through state health

insurance exchanges, premium tax credits & subsidies.• Reduces burden of uncompensated care on physicians & hospitals. • Provides tax credits for small business.

80/20 RULE

• Before the law, companies spent as much as 40 cents of every premium on overhead , marketing and ceo salaries.

• Today the new 80/20 rule says insurance companies must spent at least 80 cents of your premium dollar on your health care or improvement of services.

• If they don’t they must repay you.

ESSENTIAL HEALTH BENEFITS :

WHAT IS MARKET PLACE AND HOW IT WORKS:

• Website healthcare.org.

• All options in one place

• One application, one time

• Explore every qualified insurance plan in different areas

• Including any free or low cost insurance for which a consumer may qualify.

• There is the SHOP (Small Business Health Options Program).

MARKETPLACE EXCHANGE TYPES

INDIVIDUAL MANDATE

• By April 1st 2014 all non-exempt Americans will have to enrol in health insurance, get an exemption, or face a tax penalty. If you already have health insurance you can keep it. For many low to middle income Americans, insurance will become more affordable. However, those making above 400% of the federal poverty line may find themselves paying more.

PENALTIES

WHO IS ELIGIBLE FOR THE NEW TAX CREDITS?

• Eligibility for the new tax credit is based on .

• Household income and family size for the year .

• Income between 100% to 400% of the Federal Poverty Level (FPL).

($23,550 – $94,200 for a family of four in 2013).

• Tax credit amount depends on income as percentage of the Federal Poverty Level (FPL) .

• For 2014, the Obamacare tax credit for the small businesses is as much as 50% of the premiums you pay. This will continue through 2015 (after this, the program is slated to end).

• Limits premium payments as a percent of income .

REALITY

• Obamacare would shift more 83.4 million Americans from private health care coverage to the government plan. To put that in perspective, that would mean that nearly half (48.4 percent) would lose their private health coverage. In all, the government plan would have 103.4 million members once implemented, according to the analysis. President Obama has repeated the mantra that anybody who likes their health insurance plan can keep it, but in reality about 63 percent of covered Americans get their health care through their employers, and if employers decide to drop their current health plans in favor of the government plan, workers won’t have any choice but to sign up.

EFFECT ON OLD PEOPLE

• More people to take the medicare services in current future.

• Remove donut hole.

• Expands coverage and wellness visits without charging you.

• This reform has been active since 2011 and gives seniors better access to cancer screenings, wellness visits, personalized prevention plans, vaccines, flue shots

• Fewer plan choices.

• Less access to physician.

• More medicare payment cuts.

TAXING TRUTH ABOUT OBAMACARE :

• 20 NEW OR HIGHER TAXES on American families and small businesses.• $500 billion+ in tax hikes (over the next 10 years).

1. $123 BILLION (January 2013) Surtax on Investment Income.

2.New 3.8% SURTAX ON INVESTMENT INCOME earned in households making at least $250,000 ($200,000 single)

3. $86.8 BILLION (January 2013) Hike in Medicare Payroll Tax.

4.$60.1 BILLION (January 2014) Tax on Health Insurers Annual tax.

relative to health insurance premiums collected that year .

5. $65 BILLION(January 2014) Individual Mandate Excise Tax Combined total with Employer Mandate Tax.

Starting in 2014, any individual NOT BUYING “qualifying” health insurance MUST PAY an income surtax according to the rules:

INDIVIDUAL MANDATE AND TAX PENALTIES

• Your tax penalty (shared responsibility fee) for not having insurance is paid on your federal income taxes at the end of the year. If your taxable income is below 133% of the federal poverty level you are exempt from this tax.

• 2014 = $95 per person per year or 1% of your Income2015 = $325 per person per year or 2% of your Income2016 = $695 per person per year or 2.5% of your Income2017 = Tax Penalty will increase by the rate of inflation going forward, or 2.5% of your Income

• The penalty will be applied to your year-end federal modified adjusted gross income for each month if you don't have health insurance or an exemption.

THE EMPLOYER MANDATE FEE / EMPLOYER SHARED RESPONSIBILITY PAYMENT

• It is a per employee fee for employers with over 50 full-time equivalent employees who don't offer health coverage to full-time employees.

• The fee is based on whether or not you offer affordable health insurance to your employees that provides minimum value.

EFFECT ON ECONOMY

• By 2021, there will be 2.3 million full-time less workers.This represents a 1.5 to 2 % reduction in the numbers of hours worked, The Wall Street Journal reported.

• People whose employment or hours worked will be most affected by the ACA are expected to have below-average earnings .That means lesser production and lesser growth.

• Affordable Care Act is driving businesses and people to choose government-sponsored benefits rather than work.

Pharmaceutical companies• 32 million formerly uninsured citizens becoming potential

customers.• $115 billion of new business over a period of 10 years.• Higher rebates for prescription drugs provided through the

Medicaid programs will cost the industry about $20 billion over the next decade.

• Drug-makers must also pay new “excise taxes on branded drugs, which are expected to reach $30 billion by 2021,”

DEFICITS

The government would collect a net of $8 billion through "risk corridor payments" from health insurers from 2015 - 2017.

The CBO said the deficit will fall to $514 billion in the fiscal 2014 year ended Sept. 30, down from its previous estimate of $560 billion and a fiscal 2013 deficit of $680 billion.

DEFICIT IN FUTURE:

• The deficit will decline to $478 billion in fiscal 2015.

• The deficits will start to grow steadily thereafter as the economy struggles with an unemployment rate that fails to fall below 6.0 percent until late 2016.

• The costs of absenteeism and productivity losses on the job at more than $200 billion annually, or about 1.5 percent of G.D.P.

OUTSOURCING IT JOBS TO INDIA

• Illinois Governor administration awarded a ten year $71.4 million staffing contract to Cognizant Technology Solutions.

• And more to come .

ANY QUESTION!

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MEDICARE

A U.S. federal health program that subsidizes people who meet one of the following criteria:

1. An individual over the age of 65 who has been a U.S. citizen or permanent legal resident for five years.

2. An individual who is disabled and has collected Social Security for a minimum of two years.

3. An individual who is undergoing dialysis for kidney failure or who is in need of a kidney transplant.

4. An individual who has Amyotrophic Lateral Sclerosis (Lou Gehrig's disease).

EFFECT ON SENIORS CITIZENS

• Half of those covered will no longer be able to keep the coverage they have.

• New taxes on drug companies ($27 billion) and medical device makers ($20 billion) Fewer plan choices.

• Less access to physicians.

• More Medicare payment cuts.

• Higher taxes.

E

ENSURES FAIR TREATMENT FOR PATIENTS AND PROVIDERS

New protections end the worst insurance industry excesses & abuses:

•Health care premiums more than doubled in past 10 years, while insurance company profits rose

•Law will prevent denials of coverage, including for pre-existing conditions

•Insurers can’t cancel coverage because a patient made a mistake on their coverage application

•Insurers won't be able to charge women more than men

••Insurers are also required to spend 80-85% of premium dollars on patient care

E

ENSURES FAIR TREATMENT FOR PATIENTS AND PROVIDERS

New protections end the worst insurance industry excesses & abuses: • •Health care premiums more than doubled in past 10 years, while insurance company

profits rose • •Law will prevent denials of coverage, including for pre-existing conditions • •Insurers can’t cancel coverage because a patient made a mistake on their coverage

application • •Insurers won't be able to charge women more than men • •Eliminates lifetime benefit limits and phases out annual limits • •Insurers are also required to spend 80-85% of premium dollars on patient care

EFFECT ON DOCTORS

• Obamacare expands government's role as the primary payer of health care by adding 18 million people to the Medicaid program, which on average reimburses doctors only 56 percent of the market rate for medical procedures.

• Due to increased regulation and less reimbursement, 66 percent of doctors are considering no longer accepting government health programs

EFFECT ON FAMILIES AND FUTURE GENERATION

• Obamacare adds a trillion dollars in new health care spending.• New Obamacare spending includes $125 million per year for

school-based health centres.