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Affordable care act . Consumer impact. What’s changing with the ACA?. What’s not changing with the ACA? Will have broad impact that affects some population groups more than others. Impact by insurance status. Impact greatest on uninsured/underinsured
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Affordable care act Consumer impact
What’s changing with the ACA? • What’s not changing with the ACA? • Will have broad impact that affects some population groups more than others
Impact by insurance status • Impact greatest on uninsured/underinsured • Significant impact on people who have Medicaid • Lesser impact on people who have Medicare • Lesser impact on people who have private insurance
Effect on uninsured • Access to coverage through marketplace • Uninsured adults under age of 26 may qualify under parents’ plans • Mandatory participation • Premiums • Subsidies for people with low incomes
Effect on underinsured • Access to coverage through marketplace • Elimination of lifetime limits on coverage • Standardization of benefits • Coverage of preventive care
Effect on Medicaid beneficiaries • New services funded by Balancing Incentive Program and 1115 Transformation Waivers • Community First Choice • Nursing home relocation services
Effect on medicare beneficiaries • Help with prescription drug costs • Greater access to preventivecare • Annual wellness physical
Effect on dual eligibles • Greater emphasis on coordination of care • Transition from fee-for-service to managed care
Effect on privately insured • Can retain current coverage, if satisfied • Exempt from fees that uninsured people required to pay • Can purchase plan from marketplace, but employer not required to help pay premium
Effect on all insured people • Focus on outcomes • Incentives for adopting healthy lifestyles • Coordination of acute and long-term services and supports