1. Ryan DiBattista

2.  Medicaid:  -specifically targeted at individuals and families on low income and few resources.  - means tested program which is funded by the state and federal governments and managed on an individual state-by-state basis.  - It is believed that 60% of those on low incomes are not actually covered by the Medicaid system.

3.  A simplified definition would be to look at the United Kingdom’s National Healthcare System (NHS).  All members of the population contribute to a central pot, this central pot is then allocated to the various NHS trusts who are then legally obliged to offer services and facilities to the public.  Issues: Differences in funding and who is eligible for treatment, when compared to the U.S. system.  The NHS will not turn away any patient, therefore if you do not have health insurance in the United States, for example, and are not covered by the Medicaid system then you can take advantage of the emergency services in the event of a serious illness/accident.

4.  He wanted to introduce a system that would reduce funding for Medicaid while at the same time expanding “free healthcare” for the masses.  Anticipated cost= 1 trillion dollars over the next decade.  Reform was viewed as an attempt at socialized medicine, by critics of Obama and his proposed system.

5.  There are numerous cases in the U.S. where individuals lack health insurance coverage and are taken to court to pay for the care that saved their lives.  No other country in the world has the number of healthcare related bankruptcies that the U.S. has.

6.  Reduced funding for Medicaid along with caps on various treatments, medical services, and medical costs has raised awareness amongst pharmaceutical companies, private healthcare companies, insurance companies, and other related businesses are now concerned that their funding will be reduced and profits will go down.  At the same time, 47 million Americans have no health insurance. (As of 2009)  Many insurance companies have very tight and restrictive small print in various policies, which results in many people, who assume they are covered by their insurance policy, being blindsided with significant medical bills after a medical event.

7.  President Obama and his supporters targeted the rich, who will not only be asked to contribute more funding through the tax system, but also will have various tax exemptions removed.

8.  Officially= Patient Protection and Affordable Care Act of 2010  Requires that all U.S. citizens have health insurance in 2014 or be subject to a tax.  Coverage started on January 1, 2014 if you signed up by December 23, 2013.  Open enrollment through the exchanges ends March 31, 2014. If you don’t have insurance by then, you will be taxed 1% of income unless certain conditions apply.

9.  The health insurance exchanges opened on October 1, 2013.  Some exchanges are run by states, and some by the Federal government. At first, the Federally run-exchange made you wait hours, if you could register at all. However, the issue has been resolved and plans can now be compared. To compare= the monthly premium, but overall anticipated health costs. This includes: annual deductible, percentage covered, and co-payments.  If you already had insurance, you can keep it if: 1) It was in existence before March 23, 2010. In that case,,it’s been grandfathered in. 2) Your employer keeps its plans. However, many companies are using this opportunity to dump or change how they provide health insurance. 3) Your insurance company keeps it. Many have cancelled plans that don’t meet minimum requirements.

10.  All insurance plans must provide essential services in 10 health benefits categories. In addition, those with pre-existing conditions can no longer be excluded (children in 2010; adults in 2014).  The sick can no longer have their coverage be dropped.  Parents can have their children stay on their plans now until they are 26 years old.  If you have Medicare, the “donut hole” (meaning the percentage of your insurance that is uncovered by Medicare) gap in coverage will be eliminated by 2020.

11.  Medicaid will be extended to those who earn up to 133% of the Federal poverty level. That’s $15, 281 for an individual, or $31, 321.50 for a family of four in 2013. The poverty level usually increases each year to keep up with inflation.  However, not all states elected to expand Medicaid, even though the Federal government will subsidize it. If you live in a state where you are eligible for Medicaid, but the state won’t give you coverage, you won’t have to pay the tax if you don’t get insurance.  Those who earn too much for Medicaid will receive tax credits if their income is below 400% of the poverty level. In 2013, that’s $45, 960 for an individual, or $94,200 for a family of four. The credit is applied monthly, rather that as an annual tax rebate. There are also reduced co-payments and deductibles.

12.  If you don’t enroll in a health insurance plan by the end of the open enrollment(March 31,2014) you won’t be able to get insurance through the exchanges. You must have coverage for at least 9 months in 2014 to avoid the tax.  The Obamacare ruling allows the IRS to tax you 1% of adjusted gross income, but no less than $95 per adult/$47.50 per child in 2013. These taxes rise in 2015 and 2016.

13.  Taxes increased in 2013 for wealth Americans(about time), some health care providers, and other health-related businesses.

14.  The mandate to provide health insurance for your employees has been postponed to January 1, 2016 if you have 50-99 employees.  If you have more than 100 employees, you must provided insurance to at least 70% of full-time employees or pay a fine.

15.  Affordable Care Act created the National Prevention Council that coordinates all Federal health efforts to promote active, drug-free lifestyles.  If funds scholarships and loans to double the number of health care providers in five years.  It cuts down on fraudulent doctor/supplier relationships.  Also requires background checks of all nursing home staff, to prevent abuse of seniors.

16.  Main advantage of the Affordable Care Act is that it lowers health care costs overall by making insurance affordable for more people. That’s because insurance will be extended to two uninsured groups. First, young people who tend to be healthier. This lowers costs overall because they’ll pay premiums, but won’t use many services. Second, insurance will become available to people who know use expensive hospital emergency room treatments instead of going to a primary care physician. This lowers cost because they will have their conditions treated before the expensive critical stage.  Another advantage is it provides insurance more fairly. Prior to the act only people who fell into four categories could get health insurance plans: 1) Those who work for a company who provides it. 2) Those who can afford to pay on their own and who have no pre-existing conditions.3) The very poor, who have Medicaid. 4) Those who are 65 and older, who have Medicare.  If you don’t fall into one of those four categories, you are forced to pay for health care out of pocket. If you can’t afford it, either the hospital must cover the cost, or you must declare bankruptcy. The U.S. system was set up this way in the 1940’s when the Federal government gave tax breaks to companies who provide health insurance for their employees.

17.  The main disadvantage of the Affordable Care Act is that it could increase health care costs in the short term. That’s because many people will receive preventive care for the first time in their lives. This could lead to treatment of previously undiagnosed illnesses, driving up costs.(Source: CBO, 2009 Study on Preventive Health Care, August 7, 2009)2009 Study on Preventive Health Care  Most of the disadvantages are building amongst those individuals and businesses that are paying higher taxes.  In addition, somewhere between 3-5 million workers could lose their existing, company-sponsored health insurance if their company finds it more cost-effective to let them buy it on their own and pay the penalty.  The costs of Obamacare has been seen as both a positive and a negative. It depends on what information you have been exposed to. Estimates range from $1.76 trillion added to the debt, on top of $143 billions dollars as it is now.

18.  The Affordable Care Act means more time with their doctors for seniors and important new benefits like free preventive services like cancer screening and annual wellness visits, but also means more money in their pockets.  The new healthcare act makes Medicare stronger.  Already, more than 5.1 million seniors and people with disabilities saved over $3.2 billion in drug costs. That equals out to an average savings of $635/person for seniors caught in the coverage gap known as the “donut hole”.  Also, 32.5 million people with Medicare have received preventive service without a co- pay/deductible, thanks to the new law.

19.  You get free preventive services- Medicare now covers certain preventive services, like mammograms or colonoscopies, with no cost sharing. You can also get a free annual wellness visit.  You get cheaper prescription drugs- If you’re in the “donut hole”, you will receive a 50% discount when buying brand-name prescription drugs covered by Medicare Part D. This discount is applied automatically when you fill your prescription---you don’t have to do anything to get it. These changes are already saving seniors billions of dollars. And by 2020, the “donut hole” will be closed.  Your doctors are supported to better coordinate your care- Many doctors, hospitals, and other providers are taking advantage of new programs to help them work better as teams to provide you the highest quality of care possible. They are working to get you the care you need at the time you need it.  The law fights fraud and strengthens Medicare- The Affordable Care Act builds up on our efforts to combat fraud and abuse. These efforts are saving billions of dollars in money that was being stolen from people and Medicare. Thanks to efforts and improvements, the life of the Medicare Trust Fund has been extended.  Your Medicare coverage is protected- Under the new health care law, your existing Medicare- covered benefits won’t be reduced or taken away. As always, you will be able to choose your own doctors.