SIX MONTH ANNIVERSARY of the AFFORDABLE CARE ACT

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1 SIX MONTH ANNIVERSARY of the AFFORDABLE CARE ACT SEPTEMBER 2010 ACTION GUIDE

2 SIX MONTH ANNIVERSARY OF THE AFFORDABLE CARE ACT SEPTEMBER 2010 ACTION GUIDE After a year of striving, after a year of debate, after a historic vote, health care reform is no longer an unmet promise. It is the law of the land. President Barack Obama following the signing of the Affordable Care Act, March 23, 2010 September 23, 2010 marks the six month anniversary of the Affordable Care Act, the landmark new law that will put into place comprehensive health insurance reforms that will hold insurance companies more accountable, lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans. Critical insurance reforms will begin to be implemented on September 23, and it is important that consumers have information about the new benefits and rights available to them under the new law. This packet includes talking points regarding the new law and sample event and public education ideas your organization may consider implementing on the national, regional, or local levels. If you have additional questions, please do not hesitate to contact the Office of Health Reform. Key Points 3 State by State Statistics 5 September 2010 Action Items 6 2

3 KEY POINTS ON THE SIX MONTH ANNIVERSARY OF THE AFFORDABLE CARE ACT On March 23, 2010, Congress passed and President Obama signed the Affordable Care Act into law. Six months later, on September 23, a critical new Patient s Bill of Rights kicks in that puts an end to some of the worst insurance abuses and puts consumers, not insurance companies, in control of their health care. Consumers will also be provided with some important new benefits to improve and expand insurance coverage. These new protections include: Ban of Discriminating Against Kids with Pre-Existing Conditions Before reform, tens of the thousands of families have been denied insurance each year for their children because of an illness or condition. Starting September 23, 2010, those plans cannot discriminate against kids with pre-existing conditions. In 2014, no one seeking coverage can be discriminated against because of a preexisting condition. Up to 72,000 uninsured children are expected to gain coverage by banning insurers from refusing them coverage due to a pre-existing condition. Coverage for up to 90,000 children will no longer exclude benefits because of a pre-existing condition. Ban on Insurance Companies Dropping Coverage Before reform, insurance companies could cancel your coverage when you were sick and needed it most because of a simple mistake on your application. Starting September 23, 2010, insurance companies are banned from cutting off your coverage due to an unintentional mistake on your application. The approximately 10,700 people whose coverage is dropped each year because they get sick or make a technical mistake on their application will be protected under the new law. Ban on Insurance Companies Limiting Coverage Before reform, cancer patients and individuals suffering from other serious and chronic diseases were often forced to limit or go without treatment because of an insurer s lifetime limit on their coverage. Starting September 23, 2010, insurance companies can no longer put a lifetime limit on the amount of coverage, so families can live with the security that their coverage will be there when they need it most. The use of annual limits will be restricted and will be banned completely in Up to 20,400 people who typically hit their lifetime limits on the dollar amount that can be spent on coverage, along with the nearly 102 million enrollees on whom insurers impose lifetime limits, will no longer have to worry about hitting their benefits caps. By 2013, up to 3,500 people per year will maintain coverage as a result of the ban on annual limits that insurers impose on nearly 18 million people today. 3

4 Ban on Insurance Companies Limiting Choice of Doctors Before reform, insurance companies could decide which doctor you could go to. Starting September 23, 2010, if you purchase or join a new plan, then you have the right to choose your own doctor in your insurer network. Up to 88 million people will benefit from this provision by Ban on Insurance Companies Restricting Emergency Room Care Before reform, insurance companies could limit which emergency room you could go to or charge you more if you went out of network. Starting September 23, 2010, if you purchase or join a new plan, those plans are banned from charging more for emergency services obtained out of network. Up to 88 million people will benefit from this provision by Guarantee You a Right to Appeal Before reform, when insurers denied you coverage or restricted your treatment, you were left with few options to repeal. Starting September 23, 2010, if you purchase or join a new policy, you will be guaranteed the right to appeal insurance company decisions to an independent third party. Up to 88 million people will benefit from the new appeals process provisions by Covering Young Adults on their Parents Plan Starting September 23, 2010, young adults will be allowed to remain on their parents plan until their 26 th birthday, unless they are offered coverage at work. Up to 2.4 million young adults, up to 1.8 million who are uninsured, and nearly 600,000 who purchase more expensive coverage in the individual market could gain affordable coverage through this provision of the new law. Covering Preventive Care With No Cost Starting September 23 rd, if you join or purchase a new plan, you will receive recommended preventive care with no out of pocket cost. Services like mammograms, colonoscopies, immunizations, pre-natal and new baby care will be covered and insurance companies will be prohibited from charging deductibles, copayments or co-insurance. Up to 88 million people will benefit from this provision by To Learn More about the Affordable Care Act go to HealthCare.gov HealthCare.gov is a new, easy to use website that helps consumers take control of their health care and make the choices that are right for them by putting the power of information at their fingertips. In addition to more information about the Affordable Care Act, the website is the first of its kind to bring information and links to health insurance plans into one place, making it easy for consumers to learn about their insurance choices and compare plans available to them. Visit today. 4

5 STATE BY STATE STATISTICS The Affordable Care Act will strengthen health care for all Americans in states across the country. Visit to find the following data and additional information for your state: Number of Medicare beneficiaries who hit the donut hole, or gap in Medicare Part D drug coverage, and received no additional help to defray the cost of their prescription drugs and the number of residents who have already received their $250 tax free rebate. Number of Medicare beneficiaries who will receive free preventive services. Funding allocated for the new Pre-Existing Condition Insurance Plan program, funded entirely by the Federal government. The program is a bridge to 2014 when Americans will have access to affordable coverage options in the new health insurance Exchanges and insurance companies will be prohibited from denying coverage to Americans with pre-existing conditions. Number of small businesses that may be eligible for the new small business tax credit that makes it easier for businesses to provide coverage to their workers and makes premiums more affordable. Number of young adults who may be able to remain on their parents policy until they turn 26, unless the adult child has another offer of job-based coverage in some cases. Number of people who retired before they were eligible for Medicare and have health coverage through their former employers. Employers may be eligible to join the Early Retiree Reinsurance Program which will help stabilize early retiree coverage and help ensure that firms continue to provide health coverage to their early retirees. Companies, unions, and State and local governments are eligible for these benefits. To see a list of employers participating in the Early Retiree Reinsurance Program, visit Number of residents with health insurance from their employer who will be protected from restrictive annual limits on care. 5

6 SEPTEMBER 2010 ACTION ITEMS There are a number of ways to communicate with your members and answer questions regarding the Affordable Care Act. We encourage you to work with your local partners and chapters to organize events in communities across the country. Possible events and communication opportunities include: Gather a group of leaders and members from your organization for a public roundtable discussion about how the Affordable Care Act will improve the health care system. Distribute an to your organization s national, regional, and local lists outlining the benefits of the Affordable Care Act and encouraging readers to visit for more information. Hold a press conference marking the six month anniversary of the new law with representatives of your organization that help show how people will benefit from the Affordable Care Act. Have individual members tell their story about how they will benefit from the new law. Encourage your state and local chapters to hold a conference call or tele-town hall with their local members to discuss the benefits of the law. Conference calls could feature leaders from your organization discussing the benefits and taking questions Hold a public meeting with members of your organization to demonstrate how to use to help understand the new law and identify coverage options that may be available in your area. Encourage local leaders from your organization to draft op-eds and letters to the editor in newsletters, newspapers, and other local publications regarding the Affordable Care Act. Distribute information regarding the Affordable Care Act in your organization s national, regional, and local publications. 6