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Affordable care act

Affordable care act

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Affordable care act

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Presentation Transcript

  1. Affordable care act Consumer impact

  2. 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

  3. 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

  4. 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

  5. Effect on underinsured • Access to coverage through marketplace • Elimination of lifetime limits on coverage • Standardization of benefits • Coverage of preventive care

  6. Effect on Medicaid beneficiaries • New services funded by Balancing Incentive Program and 1115 Transformation Waivers • Community First Choice • Nursing home relocation services

  7. Effect on medicare beneficiaries • Help with prescription drug costs • Greater access to preventivecare • Annual wellness physical

  8. Effect on dual eligibles • Greater emphasis on coordination of care • Transition from fee-for-service to managed care

  9. 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

  10. Effect on all insured people • Focus on outcomes • Incentives for adopting healthy lifestyles • Coordination of acute and long-term services and supports