Script for Health Care for All New York PowerPoint

Transcription

1 American Cancer Society Cancer Action Network Children s Defense Fund/New York Community Service Society of New York Empire Justice Center Institute for Puerto Rican and Hispanic Elderly Make the Road New York Medicare Rights Center Metro New York Health Care for All Campaign New Yorkers for Accessible Health Coverage New York Immigration Coalition Public Policy and Education Fund of New York/Citizen Action of New York Raising Women s Voices Schuyler Center for Analysis and Advocacy Script for Health Care for All New York PowerPoint This is a script for a PowerPoint produced by Health Care for All New York ( that provides a basic introduction to the Patient Protection and Affordable Care Act. To receive the PowerPoint itself, please Bob Cohen of the Public Policy and Education Fund and Citizen Action of New York at bcohen@citizenactionny.org. INTRODUCTION SLIDE 1 (TITLE) Good [afternoon], my name is and I am the (title) of (organization). Thank you for being here today. (organization) is one of many groups that fought hard over the past two years to win health care reform. SLIDE 2 Our group is a member of Health Care for All New York, a coalition of over 150 health advocates and consumer rights groups whose goal is to make sure everyone in New York has the quality, affordable, comprehensive health care they need. SLIDE 3 It s been a long road to get to this point. After months of battling it out in Washington, on our TV airwaves and across cities and towns all over America, a new health care law was passed in 2010 March 2013 is the law s third anniversary! The year 2013 is particularly important because in October, the new state health Exchange will begin enrolling people. The Exchange is a state agency that will provide cheaper health insurance for individuals and families that don t have coverage through other means like their employer. SLIDE 4 The ACA is certainly not perfect. But today, I want to share with all of you why it was still well worth the fight. I ll talk about how millions of people are beginning to see their lives change for the better through the law. Congress and President Obama strongly debated and eventually passed what is truly historic legislation: legislation that I believe someday will be looked at by every American as part of the benefits they are entitled to from our government: just like Social Security is today. We hope that today s presentation will help you understand the law and that you will share this information with your family, friends, coworkers and community. Over the next half hour or so we ll do a few things: March

2 SLIDE 5 First, we ll remind ourselves why we needed health care reform, why it was so important to win. CLICK Second, we ll talk about what we will get from the law. CLICK And, we ll recap by giving you some of the benefits of the law. WHY WE NEEDED REFORM SLIDE 6 Let s first discuss why reform was so important. As I go through this list, I d like you to think of the people in your life. Who do you know who has been in one of these situations? Maybe it s you or a member of your family. SLIDE 7 Right now there are over two and a half million New Yorkers without health insurance -- close to 50 million people without insurance in the United States. CLICK That s like if everyone on the east side of the Mississippi didn t have health care! SLIDE 8 Many others are underinsured : they have health insurance, but it simply doesn t provide adequate coverage. These are the folks that if someone in their family got really sick or into an accident, their insurance wouldn t cover everything and the out-of-pocket costs would send their family into financial disaster. SLIDE 9 We can t forget that so many of us just can t afford the insurance we have, even when our employer provides it! Employees pay large amounts out of our own pockets for our share of our premiums, which lowers each pay check, and that doesn t even include co-pays and deductibles! If a family doesn t have insurance through their job, buying quality health coverage on their own is now difficult or impossible for most low or moderate income people to afford. SLIDE 10 For all these reasons and others, right now 3 of 5 bankruptcies in America are related to medical bills. Many of those filing bankruptcy have health insurance. SLIDE 11 And let s not forget all the folks we know who have gotten sick and whose insurance company has dropped them, denied claims, or delayed them over and over again. SLIDE 12 And we have to deal with the issue of health care costs for our whole nation. Experts predicted before the law was passed that if we didn t fix health care, our annual health care expenditures nationally would nearly double in less than a decade. SLIDE 13 Who do you know who has faced one of these issues? Is it a neighbor, someone at church, a co-worker or a family member? [PAUSE] HISTORY: HOW HEALTH CARE REFORM WAS PASSED SLIDE 14 The benefits of the law came about because of a take it to the streets movement like we haven t seen in decades. SLIDE 15 A health care overhaul has been on the to do list of many presidents, starting with Teddy Roosevelt over one hundred years ago. Each time, the opponents were there to fight them, pouring in money to the campaign against it. SLIDE 16 The same was true in the early 90s during the Clinton Administration. March

3 SLIDE 17 Some of you may remember or have heard about the Harry and Louise ad campaign by the insurance industry: Harry and Louise --- depicted as the typical American couple --- are shown here. After the defeat of health care reform during the Clinton administration, passing meaningful legislation was effectively dead until Obama become President. SLIDES 18-21, CLICK ABOUT 8 TIMES SLOWLY OVER THIS PARAGRAPH This bit of history reminds us of just how hard it was to win the battle for a new health care reform law in The law was passed only after millions of people fought for it: using tactics like letter-writing and turning out at town hall meetings. It s yet another lesson that our country can take on the big problems and find big solutions that help so many of us. WHAT WE WILL GET FROM HEALTH REFORM SLIDE 22 So what exactly will we get? SLIDE 23 The law, formally called the CLICK Patient Protection and Affordable Care Act, often shortened as the Affordable Care Act or the ACA, is a plan in which individuals, businesses, and government all have a role in making sure as many people as possible get quality, affordable health coverage. Here s some protections that consumers are already benefiting from: SLIDE 24 Seniors and people with disabilities will have access to cheaper prescription drugs. Before the law, they had to pay the full cost of their prescription drugs after incurring around $3600 in drug costs under their Medicare Part D plans until their costs got so high that what is known as catastrophic coverage kicked in. SLIDE 25 This is called CLICK (LETTERS FALL) falling into the donut hole. SLIDE 26 Because of the law, seniors and the disabled in the donut hole received a $250 rebate check in And in 2011, a manufacturer s discount kicked in: seniors and people with disabilities only had to pay 50% for brand-name drugs and 93% for generics. The average savings per person has been almost $700 so far. SLIDE 27 Children with pre-existing conditions -- conditions they were treated for before their parents sought coverage for them -- CLICK can t be denied coverage anymore. Over one million New York kids are now protected. Adults will be protected starting in Preexisting conditions can include a wide range of problems, from cancer to even domestic violence, under the rules of some insurers! Insurers are no longer able to impose waiting periods of up to one year before kids with pre-existing conditions can get coverage. SLIDE 28 Insurers can t drop you anymore when you get sick: CLICK a practice called rescission: less of a problem in New York than many states, but still an important protection. SLIDE 29 The law requires both private health plans and Medicare to cover -- at no charge -- preventive services like CLICK mammograms and CLICK colonoscopies and CLICK an annual wellness visit. This is a critical step to prevent illness, and it will save many consumers hundreds of dollars in a single year! March

4 SLIDE 30 A federal tax credit allows small businesses that pay for at least half of the cost of their employee s health insurance to have up to roughly CLICK one-third of the cost of paying for their employees health insurance covered. Roughly 285, of 5 New York small businesses -- are eligible for the credit. SLIDE 31 Health insurance premiums will not go up as much as they would otherwise without reform. Under a state law passed in 2010, the State Department of Financial Services formerly the Insurance Department -- can reject proposals by health plans for increases to the premiums you and your employer pay if they are too high. As a result, rate increases for people with private coverage have been kept in check. And 1 million New Yorkers received rebates from health insurers in 2012 because the health plans violated laws requiring that a minimum percentage of each premium dollar be used for our health care rather than for their corporate profits and administrative costs. SLIDE 32 The law also bans lifetime limits on the amount of medical coverage your insurer will pay for you. CLICK This used to happen all the time, when your medical expenses would go over a certain amount and the insurer suddenly tells you you re not covered anymore. If you, say, had a million dollars in medical expenses because of a serious disease like cancer -- no more coverage! Unreasonable annual limits are banned too. SLIDE 33 These new legal protections -- like bans on annual and lifetime limits and requirements that health plans cover you even if you had a pre-existing condition -- are incredibly important for all of us: even if you have insurance through your job right now. The law creates a basic guarantee of health security. Because of the law, if you lose your job and your insurance coverage, you won t be denied coverage when you do find a new job. And you won t have your life savings wiped out by an unexpected serious illness. SLIDE 34 And finally, we now have help navigating the health insurance maze! To help consumers and small businesses with the confusing tasks of selecting and enrolling in health plans and resolving disputes with health insurers, doctors and hospitals, a network of community-based organizations called Community Health Advocates has been formed with funding provided under the law. Services are provided in every region of New York State, at no charge. Here in [region/neighborhood], you can contact the program by calling [XXX- XXX]. Small Businesses and Non-Profits SLIDE 35 Now, let s get to how the law helps small businesses and their employees. SLIDE 36 The law provides small businesses with tax credits to encourage them to provide their employees with health insurance. Small businesses are not required to provide employees with health insurance -- it s the right thing to do and helps keep good employees. Small businesses get the credit just by applying through their annual tax form. Non-profits are eligible too, but the rules are somewhat different. As you can see from the slide, 285,000 small businesses are projected to be eligible for the credit. SLIDE 37 To qualify for these tax credits, a small business can t have more than 25 employees, and the average annual wages for its employees can t be more than $50,000. March

5 SLIDE 38 For the first three years of the law, the smallest firms with low-waged workers will get a credit of up to 35% of the employers share of the premiums they pay for their employees health coverage. Slightly bigger firms or those with higher wages get a smaller credit than 35%. SLIDE 39 In 2014, things will get even better: the maximum tax credit will cover up to 50% of a business share of its employee premiums. Larger employers SLIDE 40 Bigger businesses are subject to different rules. Businesses of 50 or more employees may have to pay a penalty if they don t offer health coverage or if the coverage they do offer costs too much for their employees. SLIDE 41 Smaller businesses with less than 50 employees don t have to offer coverage but can use the state health Exchange that I ll explain in a minute to purchase insurance at a cheaper rate than they could have otherwise bought outside the Exchange. Exchanges SLIDE 42 One of the biggest reforms of the law is coming in 2014: the new health insurance exchanges, which will allow small businesses and individuals who don t have coverage through their jobs to buy insurance at cheaper rates. Exchanges are being set up in every state. The New York Exchange was established through a 2012 Executive Order by Governor Cuomo. SLIDE 43 The Exchange is a state agency with a web page and phone and in person assistance where you can purchase health insurance. And, like at COSTCO or B.J. s Wholesale Club, small businesses, the self-employed and individuals will be able to get cheaper private coverage because so many people are buying through the Exchange. Studies done for New York State estimated that individuals and families will save 66% and small business employees will save over 20%! Because of the law, insurance companies won t be allowed to sell any product they want through the Exchange, no matter how bad it is. And marketing rules will prevent insurers from making sleazy claims about the insurance they sell. CLICK The State will act as a cop on the beat who regulates the health insurance products that can be sold there. Insurers will have to meet certain requirements to ensure quality coverage. Consumers and businesses will have some choices of plans. For example, there will be different plan levels called Bronze, Silver, Gold and Platinum: each with different costs to consumers. But all plans will have the essential benefits that any good health plan should have, including coverage for doctor s visits, hospital care, maternity care, mental health, prescription drugs, and rehabilitation services. SLIDE 44 The Exchange will have a call center and in-person assistance available to help you figure out what to buy, and most people will be able to enroll pretty easily online. SLIDE 45 The Exchange is already being set up: staff has been hired, and they re preparing for the launch in October. The first open enrollment period begins on October 1 st, 2013 and health coverage will begin on January 1 st March

6 SLIDE 46 The State projects that over one million people will enroll through the Exchange: roughly 615,000 individuals and 450,000 employees of small businesses. Requirement of Individuals to Obtain Coverage and Subsidies SLIDE 47 Through the Exchange, private health insurance will be more affordable and accessible for small businesses, individuals and families. People who quality will also be able to enroll in public programs using the Exchange. SLIDE 48 One of the main reasons private coverage will be more affordable through the Exchange than before is that individuals and families who earn less than 400% of the federal poverty level -- $94,200 for a family of 4 in will qualify for financial help from the government to buy insurance, called premium tax credits. CLICK The amount of the financial help you will depend on your income: lower income people will get bigger subsidies. Subsidies to buy insurance are critical, because the Affordable Care Act requires all U.S. citizens and legal residents to have coverage. I know many -- maybe some people here -- don t like this requirement. But this is necessary to keep costs down for everyone. If healthy people could avoid buying health insurance, the cost of coverage for everyone else would go through the roof. This is just like auto insurance: even if you ve never had a car accident and think you never will, you still have to buy insurance. And having lots of people without insurance increases all of our taxes, since many uninsured continue to depend on emergency rooms for their primary care, which all taxpayers pay for. The U.S Supreme Court said in its 2012 health care decision that it did not violate the U.S. Constitution for the law to mandate that everyone have health coverage. SLIDE 49 What happens if you don t buy health insurance? You ll pay a small penalty: much lower than many people believe. This penalty will be phased in, year by year: it starts at the greater of $95 or 1% of your income in 2014, and rises to $695 or 2.5% of your income by And if you can prove you simply can t afford health insurance, you won t have to pay the penalty. Cost Sharing Limits SLIDE 50 The costs you pay as a health consumer are not just your monthly premiums. As we said before, people pay huge amounts out of their own pockets -- sometimes thousands in a year - - for co-payments and deductibles. So, the law puts limits on your out-of-pocket costs. The absolute maximum people who purchase coverage through the Exchange will have to pay in one year is roughly $6000 for individuals and $12,000 for family policies in 2010 dollars. Most health people will never hit this annual maximum. People who make less than 400% of the federal poverty line -- again, about $94,200 for a family of 4 in will pay a lot less. WHAT DOES REFORM DO FOR MAJOR GROUPS OF NEW YORKERS? That s the basic outline of the law for most people. But I d like to briefly mention how the law affects a few groups. March

7 Seniors and People With Disabilities SLIDE 51 Seniors and people with disabilities are among the biggest beneficiaries of the Affordable Care Act, despite the dishonest tactics used by opponents of the law to scare them. SLIDE 52 First, as I mentioned before, seniors and people with disabilities who fell into the donut hole were automatically sent a $250 rebate check by Medicare in 2010 and began getting discounts on their prescription drugs in SLIDE 53 The discount will increase year by year, and by 2020, the donut hole will close completely: you ll only have to pay the normal 25% co-pay you have to pay now for prescription drugs. SLIDE 54 And, Medicare now covers preventive services like mammograms and colonoscopies at no charge. SLIDE 55 Third, the law cracks down on waste, fraud and abuse and overpayments to providers and private insurers, helping to protect both seniors and people with disabilities -- also helping to make Medicare solvent. The stories you may have heard that the law cuts your Medicare benefits are scare tactics used by opponents of the law and simply untrue. Children and Young Adults SLIDE 56 What about children and young adults? SLIDE 57 We ve already mentioned that kids with pre-existing conditions like cancer can t be denied coverage. There are two other significant protections. SLIDE 58 First, adult children can now stay on their parents health insurance up to age 26 at cheaper group rates. As of December 2012, 160,000 young adults had already obtained coverage under this section of the law. And in New York CLICK, because of a state law, people between the ages of 27 and 29 can keep coverage under the health plans of their parents employers, but the coverage is more expensive. SLIDE 59 Second, Child Health Plus, New York s program for covering children, will be maintained until Since Child Health Plus is comprehensive and affordable, it will remain an important coverage option for many low and moderate income families. Low Income People SLIDE 60 What about low-income people? The law expands Medicaid to low-income people with somewhat higher incomes than the maximum eligibility limit before the law was passed. As a result, up to 70,000 additional adults will gain coverage. CLICK And its estimated that 440,000 more low-income New Yorkers -- adults and kids -- that are already eligible but not enrolled will now decide to enroll. You may have heard that some states are not expanding Medicaid as a result of the U.S. Supreme Court decision that said they didn t have to. Happily, New York has decided to expand Medicaid. Immigrants SLIDE 61 Finally, let s talk about immigrants. The federal law is a mixed bag for them. March

8 On the one hand, lawfully present immigrants can purchase health insurance through state exchanges and are eligible for the premium tax credits I mentioned before to buy insurance. SLIDE 62 On the other hand, undocumented immigrants are not only not eligible for premium tax credits, but are not allowed to purchase private health insurance through state exchanges CLICK, even if they are willing to pay the full cost for their coverage. This is a case where unfortunately prejudice won over good health policy and common sense. Despite the problems with the health care law, undocumented immigrants should not be afraid to seek medical care in New York: they will not be turned away or turned in to immigration authorities. CONCLUSION SLIDE 63 Now, we ve gone through the major parts of the law. Now that you know a bit of what s in there, how many people here will directly benefit from one of its provisions or are close to someone who will? [PAUSE] When you consider that the law gives everyone greater economic security, I d say everyone here. So there you have it. Why we needed it, what we got. This legislation does an incredible amount of good for hundreds of millions of people. And, like other major reforms, like Medicare in 1965, we believe it will eventually become part of the social fabric of our nation as people become used to the benefits. There s a lot that can be done to improve the law, so we also have to keep informed and active! But let s remind ourselves in the meantime that the fight to pass the law was well worth fighting for! SLIDE 64 Over 1 million people will soon have access to quality, affordable coverage through the Exchange. Over a half million additional people will be covered through Medicaid alone. SLIDE 65 Roughly 285,000 New York small businesses are eligible for tax credits to buy health insurance for their employees: 4 out of 5 New York small businesses. SLIDE ,000 seniors and people with disabilities got a check in 2010 for their prescription drug costs. The average savings per person has been almost $700. These savings will continue to grow. SLIDE ,000 young adults up to age 26 have already gotten coverage through their parents health plans. SLIDE million people on Medicare and 3.3 million people with private coverage received free preventive services in 2011 alone. SLIDE 69 And the law creates the greatest expansion of the nation s social safety net since Medicare in SLIDE 70 Thanks for listening. If you want more information on what we talked about today, you can visit Health Care for All New York s web page: March