Healthcare in America

1. Healthcare in America What You Should Know

2. The League of Women Voters • Nonpartisan, but political • Established: 1920 • 1972: Men accepted • Educate & Advocate

4. What We’re Going to Cover Health insurance terms Health insurance types Health care in the U.S.

5. What We’re Going to Cover Health insurance terms Health insurance types Health care in the U.S.

6. Insurance Terms

7. Insurance Terms

8. What We’re Going to Cover Health insurance terms Health insurance types Health care in the U.S.

9. Health Insurance Types

10. Health Insurance Types

11. Private Insurance Preferred Provider Organization (PPO) Healthy Maintenance Organization (HMO) Indemnity

12. Preferred Provider Organization (PPO) Network of providers May use Out-of-Network providers Pay less In-Network

13. Health Maintenance Organization (HMO) Network of providers Out-of-Network: Emergencies Only Coverage eligibility requirements Focus: Prevention

14. Indemnity Plans Reimbursement plans Pay set portion of charges

15. Health Insurance Types

16. Government Insurance Medicare Medicaid Veteran’s Administration (VA)

17. Medicare Federally administered Mostly 65+ Source of Funding Original Medicare vs. Medicare Advantage

18. Original Medicare

19. Medicare Advantage plans Medicare Part C Alternative to Original Medicare Extra Benefits Limits out-of-pocket costs

20. Medicare Part D Prescription drug coverage

21. Medigap Policies Supplemental health insurance

22. Medicaid Joint federal & state program Covers some low-income people

23. Health Insurance Types

24. Affordable Care Act (ACA) “Obamacare” Premium subsidies Prohibits restrictive & exclusionary practices Expands Medicaid coverage

25. The Coverage Gap ACA = Affordable Care Act (“Obamacare”) Source: Henry J. Kaiser Family Foundation

26. Medicaid Expansion • Closes the coverage gap • Federal funds would pay 90% of cost • State of Florida would pay 10%. • Results: • significant state budget savings • increased state revenues.

27. Medicaid Expansion by State(as of 1/4/2019) Source: National Academy for State Health Policy

28. Employer-Based Insurance and Obamacare Almost 9 million Floridians have benefitted from: • Removal of lifetime limits • Coverage of young adults until age 26 • Free preventive care

29. ACA improved individual market policies Over 1.7 million Floridians have benefitted from: • No exclusion of pre-existing illnesses • Tax credits to help pay for insurance • Women pay the same as men • Greater transparency and often better choice

30. ACA improved Medicare Over 4 million Floridians have benefitted from: • Lower costs for prescription drugs • Free preventive care and screenings • Better hospital safety incentives

31. Health Care Systems • Single Payer • Socialized Medicine • Public Option • Medicare for All

32. What We’re Going to Cover Health insurance terms Health insurance types Health care in the U.S.

33. Health Care in the U.S. How do we compare?

34. Spending on health in the OECD was about $4 000 per person on average (adjusted for purchasing powers). The United States spends almost $10 000 per person Health expenditure per capita, 2016 (or nearest year) Note: Expenditure excludes investments, unless otherwise stated. Australian expenditure estimates exclude all expenditure for residential aged care facilities in welfare (social) services. Includes investments. Source: Health at a Glance 2017.

35. Health Care in America In the U.S., we have:

36. THANK YOU! Questions? PowerPoint created by The Healthcare Committee League of Women Voters of Palm Beach County