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Obama Care And Its Impacts
The document discusses key provisions and effects of the Affordable Care Act (ACA or Obamacare). It outlines provisions such as prohibiting denial of coverage for pre-existing conditions, expanding Medicaid eligibility, establishing health insurance exchanges, and requiring individuals to have health insurance coverage or pay a penalty. The effects discussed include more people gaining health insurance coverage through Medicaid expansion or subsidies, but also higher taxes, premiums and deficits. Critics argue it will negatively impact employment and access to doctors while supporters say it ends unfair insurance industry practices.
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Obama Care And Its Impacts
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- 2. UNINSURED RATES AMONGNONELDERLY BY STATE, (2009-2010)
- 3. ACA ACCOMPLISHMENTS: • Pre-existingCondition 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.
- 4. ACA IMPROVEMENTS • ExpandingMedicaid 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.
- 5. EXPAND COVERAGE ANDBENEFITS • 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.
- 6. 80/20 RULE • Beforethe 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.
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- 8. WHAT IS MARKETPLACE 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).
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- 11. INDIVIDUAL MANDATE • ByApril 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.
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- 13. WHO IS ELIGIBLEFOR 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 .
- 14. REALITY • Obamacare wouldshift 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.
- 15. EFFECT ON OLDPEOPLE • 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.
- 18. 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).
- 19. 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:
- 20. INDIVIDUAL MANDATE ANDTAX 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 Income 2015 = $325 per person per year or 2% of your Income 2016 = $695 per person per year or 2.5% of your Income 2017 = 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.
- 21. THE EMPLOYER MANDATEFEE / 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.
- 23. 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.
- 24. Pharmaceutical companies • 32million 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,”
- 25. DEFICITS The government wouldcollect 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.
- 26. 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.
- 27. OUTSOURCING IT JOBSTO INDIA • Illinois Governor administration awarded a ten year $71.4 million staffing contract to Cognizant Technology Solutions. • And more to come .
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- 29. MEDICARE A U.S. federalhealth 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).
- 30. EFFECT ON SENIORSCITIZENS • 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.
- 31. ENSURES FAIR TREATMENTFOR 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
- 32. ENSURES FAIR TREATMENTFOR 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
- 33. 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
- 34. EFFECT ON FAMILIESAND 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.
Editor's Notes
- #2 The Patient Protection and Affordable Care Act (PPACA),[1][2] commonly called the Affordable Care Act (ACA) or "Obamacare",[3] is a United States federal statute signed into law by President Barack Obama on March 23, 2010.The ACA was enacted with the goals of increasing the quality and affordability of health insurance, lowering the uninsured rate by expanding public and private insurance coverage, and reducing the costs of healthcare for individuals and the government. It introduced a number of mechanisms—including mandates, subsidies, and insurance exchanges—meant to increase coverage and affordability.[6][7] The law also requires insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or sex.Instead of happening all together these changes phase in over time .Health care in usa had some serious issues.millions of uninsured people and people who have insurance had to pay more in comparison to other countries.
- #3 What invoked US government to pass this law , was that so much necessary to spend billions of dollar .my answer is yes . lets look at this and give them emotion touch.With the nations average 18.4% USA ahs the following variation of uninsured rates.
- #4 Talk emotionally about young adult.
- #5 But all the reforms are good , its not true .for example if we see the last point this has a serious flaw.
- #6 Explain young adult plan.Obamacare, AKA the Affordable Care Act, implements State specific health insurance exchanges which are online price comparison websites where consumers can purchase health insurance. Americans making under 400% of the Federal Poverty Level (FPL) may qualify for reduced premiums via tax credits, while those making under 250% FPL may qualify for out-of-pocket cost assistance, those making under 138% FPL may qualify for Medicaid depending on if their State has implemented Medicaid expansion.ObamaCare gives states and the federal government the option of charging insurance companies a 3.5% fee, on the cost of the premium, to sell insurance on the exchange.
- #8 There were several issues related to this , first lets take example of female who doesn’t want to have new child why will she buy maternity care and new born care and pediatric services can also be seen in this way.
- #9 Population of USA is 314 million. Obama Care's Health Insurance Marketplace, or ObamaCare Marketplace, is State's price comparison website for subsidized health insurance . Consumers will be able to compare all insurance options based on price, benefits, and quality. Small businesses with under 50 full-time equivalent employees can use a part of the marketplace called "the SHOP" The estimated cost of this website is 550 millions over the period of 3 and half years.
- #10 HHS (health and human services)In the United States, health insurance marketplaces,[1] also called health exchanges, are organizations set up to facilitate the purchase of health insurance in each state in accordance with Patient Protection and Affordable Care Act (known colloquially, and sometimes pejoratively, as "Obamacare"). Marketplaces provide a set of government-regulated and standardized health care plans from which individuals may purchase health insurance policies eligible for federal subsidies.
- #15 We have seen what laws says but what is the reality.How the people of USA has reacted towards it, what are the impacts on citizens is it good or bad .Lets see.
- #16 • ObamaCare closes the "donut hole" that was causing Seniors not to be able to afford their prescriptions. (The Medicare"donut hole" is the Part D drug coverage limit where seniors must start paying out of pocket for their prescriptions.) In 2012, seniors got a 50 percent discount when buying brand name drugs and 14 percent discount on generic drugs covered by Medicare Part D. This reform gets stronger every year, increasing coverage and closing the donut hole until it disappears in 2020. From that point on, seniors will only pay usual drug co-pays. ObamaCare expands existing coverage for seniors, including preventive care and wellness visits without charging you for the Part B co-insurance or deductible. Seniors will no longer need to put off preventive care and check-ups due to costs. This reform has been active since 2011 and gives seniors better access to cancer screenings, wellness visits, personalized prevention plans, vaccines, flue shots and more. According to the CMS Medicare beneficiaries are expected to save, on average, about $4,200 over the next 10 years due to lower drug costs, free preventive services and reductions in the growth of health spending.
- #17 Colorado and Pennsylvania New Ramp shire .the Bronze Plan is intended to have the lowest premium of the 4 new categories of plans but charge the highest out-of-pocket costs for healthcare services. For people without group insurance from an employer or other group, the Bronze plan is the minimum health insurance plan in which they can enrol that will satisfy the Affordable Care Act’s mandate for people to purchase health insurance
- #19 The new tax related provisions in the Affordable Care Act (Obamacare) include tax hikes, limits to deductions, tax credits, tax breaks, and other changes. While a few of the changes directly affect the average American, tax increases primarily affect high earners (those making over $200,000 as an individual or $250,000 as a family), large businesses (those making over $250,000), and the health care industry, while tax credits primarily affect low-to-middle income Americans and small businesses.For the majority of the 85% of Americans with health insurance the percentage of income paid in taxes won't change much, if at all
- #21 ObamaCare's individual mandate requires that most Americans obtain health insurance by 2014 or pay a tax penalty. The individual mandate goes into effect January 1st, 2014. The penalty will be applied to your year-end federal modified adjusted gross income for each month you don't have health insurance or an exemption.
- #22 The annual employer mandate fee (officially called an Employer Shared Responsibility Payment) is a per employee fee for employers with over 50 full-time equivalent employees who doesn't offer health coverage to full-time employees.The employer mandate is based on full-time equivalent employees , not just full-time employees.So basically government is taking money from rich people and giving back to poor people ,sort of Robinhood.
- #23 The annual fee is $2,000 per employee if insurance isn't offered (the first 30 full-time employees are exempt).If at least one full-time employee receives a premium tax credit because coverage is either unaffordable or does not cover 60 percent of total costs, the employer must pay the lesser of $3,000 for each of those employees receiving a credit or $750 for each of their full-time employees total.The fee is a per month fee due annually on employer federal tax returns starting in 2015 for small businesses with 100 or more full-time equivalent employees(2016 for those with 50-99). So the per month fee is 1/12 of the $2,000 or $3,000 per employee.Unlike employer contributions to employee premiums, the Employer Shared Responsibility Payment is not tax deductible.
- #24 due partly to smaller companies reducing worker hours to avoid requirements that full-time workers be offered health insurance, there will be the equivalent of 2 million fewer full-time equivalent workers.Affordable Care Act is driving businesses and people to choose government-sponsored benefits rather than work. Some workers who obtain coverage through the healthcare law may forgo employment, the CBO reasoned, while others may reduce hours. Many low-wage workers may even drop out of the workforce as a result of the law, it said.
- #25 “This reform was inevitable in the US, and while a number of the changes will negatively impact pharma’s fortunes, the overall balance could be positive, thanks to an additional 32 million formerly uninsured citizens becoming potential customers, resulting in up to $115 billion of new business over a period of 10 years.”The drug industry was a key backer of President Barack Obama’s health reform agenda, which calls for various rebates from drug makers to pay for some of the additional benefits provided to the uninsured.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 “excises taxes on branded drugs, which are expected to reach $30 billion by 2021,”
- #26 The idea of risk corridors is to compensate insurance companies that end up with bigger costs than they expected. Under the law, they must sell policies equally to everyone, regardless of their medical history, so it’s possible some insurers could end up with an especially unhealthy pool of customers.If an insurer’s actual claims in 2014 are at least 3% greater than the claims projected when the insurer set 2014 rates, the government must reimburse the insurer for half of the excess. If actual claims jump 8% beyond projected claims, the government covers 80% of the excess
- #27 The deficit will decline to $478 billion in fiscal 2015, but the gap for that year will be $100 billion larger than previously estimated. 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,
- #28 In June, Illinois Governor Patrick Quinn's administration awarded a ten year $71.4 million staffing contract to Cognizant Technology Solutions. Cognizant ranks in the national top 10 for procuring H-1B visa workers.Although people have concerns like How will Governor Quinn justify the outsourcing of state jobs to India at a time when Illinois has the second highest unemployment in the country?
- #31 Nearly one-quarter of all seniors rely on Medicare Advantage, the private health care option in Medicare. However, Obamacare makes such deep cuts to that program that 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), as well as new reporting requirements and regulations imposed on physicians, will make access to health care and services more costly and difficult for seniors under Obamacare.
- #32 Now in this slide I wll explain why there was a need of change in existing healthcare plans.
- #33 Gopalsharma
- #35 Obamacare adds a trillion dollars in new health care spending, expanding prohibitively expensive entitlements and creating a subsidy scheme that discourages work and penalizes marriage.New Obamacare spending includes $125 million per year for school-based health centers and a new program to reduce teen pregnancy, with no requirement to reduce abortions.