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The Problem Our Country Faced

The Problem Our Country Faced. Insurance companies had free rein and could discriminate against the 129 million Americans with pre-existing conditions. Premiums had more than doubled over the last decade, while insurance company profits were soaring.

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The Problem Our Country Faced

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  1. The Problem Our Country Faced • Insurance companies had free rein and coulddiscriminate against the 129 million Americanswith pre-existing conditions. • Premiums had more than doubled over the last decade, while insurance company profits were soaring. • Fifty million Americans were uninsured, tens of millions more were underinsured, and those that had coverage were often afraid of losing it.

  2. What The Supreme Court Decision Means A clear and final ruling on the law, which allows the following to remain in place: Protection from insurance company abuses Better access and more affordable health care Stronger Medicare Greater Security for Millions of American Families

  3. The Law Stops Insurance Companiesfrom Taking Advantage of You It is now illegal for insurance companies to: Deny coverage to children because of a pre-existing condition like asthma and diabetes. Put a lifetime cap on how much care they will pay for if you get sick. Cancel your coverage when you get sick. And more…

  4. These Practices used to be legal: Now they are banned for good.

  5. The Law Makes Health Care More Affordable:80/20 Rule 60% / 40% 80% / 20% BEFORE, insurance companies spent as much as 40 cents of every premium dollar on overhead, marketing, and CEO salaries. TODAY, we have the new 80/20 rule: insurance companies must spend at least 80 cents of your premium dollar on your health care or improvements to care. If they don’t, you get money back. In 2012, approximately 12.8 million Americans will receive more than $1 billion in rebates

  6. Drop in the bucket: Pueblo city government refunded $446,138 from Premium Overpayment; $27 million will be rebated to about 208,000 Colorado residents By Peter Roper, The Pueblo Chieftain

  7. The Law Makes Health Care More Affordable for Small Business Owners “In 2010, we paid close to $11,000 for employees’ health insurance. The tax credit cut our costs by over $2,000. For a small business struggling to keep health coverage, that makes all the difference. We were actually considering dropping our insurance, but the tax credit tipped the balance and helped us maintain coverage.” --Matt H. in Montana BEFORE, small businesses paid an average of 18 percent more for health insurance than large companies. TODAY, small businesses can get tax credits to help pay for coverage for their employees. About 360,000 employers who provide health insurance to an estimated 2 million workers received the tax credit in 2011

  8. The Law Increases Access for Young Adults Young adults under the age of 26 can now stay on their parents’ health plans. 3.1 Million have already done so “I honestly don’t know what we would have done…. There was no way we could have afforded it. I might not be here right now.” --Kylie L., 23, in Illinois, who credits the health care law for enabling a life-saving heart transplant

  9. The Law Increases Your Access to Affordable CareMany preventive services are available with No out-of-pocket cost • Cancer screenings such as mammograms & colonoscopies • Vaccinations such as flu, mumps & measles • Blood pressure screening • Cholesterol screening • Tobacco cessation counseling and interventions • Birth control • Depression screening • And more… Visit www.healthcare.gov/prevention for a full list.

  10. The Law Increases Your Access to Affordable Care There are new plans in every state for people who have been locked out of the insurance market because of a pre-existing condition like cancer or heart disease. This has helped 67,500 people previously locked out of the insurance market finally have the security of health coverage “When I was diagnosed, they told me I had a 60 percent chance of being cured. That's pretty good odds, but I was also terribly worried about finances. Now I don't feel like we can't afford the treatment." --Gail O. in New Hampshire For more, visit: www.PCIP.gov. In Colorado: www.GettingUsCovered.org

  11. The Law Increases Access to Providers • Has nearly tripled the number of primary care providers in the National Health Service Corps • The Corps now has more than 10,000 doctors, nurses, physical therapists, dentists and other health care providers are serving in communities of need

  12. The Law Strengthens Medicare • Free preventive services such as mammograms and colonoscopies and a free annual wellness visit with your doctor. •  In 2011 more than 32 million Americans on Medicare took advantage of these services • A 50% discount on brand-name medications for those in the prescription drug donut hole – an average savings of nearly $600 per person in 2011. The donut hole will be closed in 2020. • More than 5.2 million seniors have now saved more than $3.7 billion on their medications. • Strong anti-fraud measures, including tougher penalties for criminals. • Tools to help doctors to spend more time with you and improve care coordination – just like they do at leading hospitals such as the Mayo Clinic and Cleveland Clinic.

  13. New Health Exchanges Starting in 2014, if your employer doesn’t offer insurance, you will be able to buy it directly in an Affordable Insurance Exchange. An Exchange is an insurance marketplace for individuals and small businesses to buy coverage. Exchanges will offer you a choice of health plans that meet certain benefits and cost standards.   Members of Congress will have to buy insurance here, too.

  14. Colorado’s Health Benefits Exchange • An online marketplace where you can easily see and compare rates on Colorado health insurance plans from Colorado’s leading health insurance companies. • Colorado is a national state leader in developing a state-specific health insurance exchange • Colorado Health Benefit Exchange will open Oct’ 2013 • Passed a bill on a bi-partisan basis • Has bi-partisan appointees on the exchange board • Colorado has received $19,201,000 to build this competitive marketplace • The Exchange Committee meets the 2nd and 4th Monday from 8:30 am - 12:00 pm. • www.getcoveredco.org

  15. More Improvements to Come… In 2014: • Discriminating against anyone with a pre-existing condition will be illegal. • Insurance companies won't be able to charge women more than men. • Tax credits will make buying insurance more affordable. • New State-based Insurance Exchanges

  16. Learn More http://www.healthcare.gov/ Social Networks • Doyle Forrestal • Office of the Regional Director, Region VIII  • U.S. Department of Health & Human Services • 999 18th St. South Terrace, Suite 400 • Denver, CO 80202 • 303-844-7335 • doyle.forrestal@hhs.gov

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