Health Care & You
For too long, too many hard working Americans paid the price for policies that handed free rein to insurance companies. President Obama’s health reform law gives hard-working families the security they deserve. Thanks to the Affordable Care Act, 3.1 million more young adults have health insurance on their parent’s plan, three million seniors have received a 50 percent discount on their prescription drugs, and millions of Americans now have access to no-cost preventive services to help them stay healthy. Abusive insurance practices are becoming a thing of the past. Additionally, the Affordable Care Act helps small businesses with the cost of providing health insurance for their employees and helps doctors and other health providers care for their patients more effectively.
The new health care law builds on what works in our health care system. And it fixes what’s broken by making improvements in several key areas. It protects you from the worst insurance company abuses. It makes health care more affordable. It gives you better access to care.
Ending Insurance Company Abuses: Thanks to the Affordable Care Act, insurers can no longer put a lifetime cap on how much care they will pay for if you get sick or cancel your coverage when you make a mistake on your paperwork. Starting in 2014, health insurers will be prohibited from charging you more because you are a woman.
More Affordable Care: 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. And insurance companies must publicly justify their actions if they want to raise premiums by 10 percent or more. And States have more power to block them.
Coverage for Young Adults: Under the Affordable Care Act, young adults under age 26 can stay on their parent’s health insurance plan until age 26 – a change that has already allowed 3.1 million young adults to get health coverage and given their families peace of mind.
Coverage for Pre-Existing Conditions: The Pre-Existing Condition Insurance Plan in every State offers an option to people who have been locked out of the insurance market because of a pre-existing condition like cancer or heart disease. And under the new law, insurers can no longer deny coverage to children under age 19 because of a pre-existing condition like asthma and diabetes. Starting in 2014, health insurers will be prohibited from discriminating against anyone due to pre-existing conditions.
Preventive Benefits: All new health plans must now cover preventive services ranging from mammograms to FDA-approved birth control to vaccinations for your child, without making you pay a copay or deductible.
The Affordable Care Act expands young adults’ affordable options for health insurance and gives hard-working families the security they need and important new benefits. The new law holds insurance companies accountable, gets rid of the worst insurance industry practices and puts patients first.
Coverage for Young Adults: Under the law, most young adults who can’t get coverage through their jobs can stay on their parents’ plans until age 26 – a change that has already allowed 3.1 million young adults to get health coverage and given their families peace of mind.
Get Preventive Services: You can get free preventive services that keep you healthy. If you are in a new insurance plan, you can receive recommended preventive services, like flu shots, HIV and cancer screenings, contraceptive counseling and FDA-approved birth control, for free. Visit www.healthcare.gov/prevention for a full list of services and plan dates.
Coverage for Pre-existing Conditions: If you have been uninsured for six months and can’t buy private insurance because of a pre-existing condition, you can join the Pre-existing Condition Insurance Plan. And under the new law, no plan can deny coverage to people under age 19 because of a pre-existing condition. Starting in 2014, health insurers will be prohibited from discriminating against anyone due to pre-existing conditions.
Ending Insurance Company Abuses: The new health care law will make sure that insurers can’t deny, cap, or limit your coverage. In the past, some people with cancer or other chronic illnesses ran out of insurance coverage because their health care expenses reached a dollar limit imposed by their insurance company. Under the new health care law, insurers can no longer impose lifetime dollar limits on essential health benefits and annual limits are being phased out by 2014. Also, insurance companies can no longer drop your coverage when you get sick due to a mistake you made on your application.
More Affordable Care: 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. And insurance companies must publicly justify their actions if they want to raise premiums by 10 percent or more. And an increasing number of States have more power to block unreasonable premium increases from taking effect.
The new health care law will help save money for seniors and ensure people with Medicare can see the doctor they know and trust.
The Affordable Care Act:
View the Infographic
Cheaper Prescription Drugs: If you’re in the donut hole, you will receive a 50 percent discount when buying brand-name prescription drugs covered by Medicare Part D. The 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.
End to Limits on Care: In the past, some people with cancer or other chronic illnesses ran out of insurance coverage because their health care expenses reached a dollar limit imposed by their insurance company. Under the health care law, insurers can no longer impose lifetime dollar limits on essential health benefits and annual limits are being phased out by 2014. More than 105 million Americans no longer have lifetime limits thanks to the new law.
Free Preventive Services: Medicare now covers certain preventive services, like mammograms or colonoscopies for free. You also can get a free annual wellness visit.
Better Coordinated Care: Many doctors, hospitals, and other providers are taking advantage of new options to help them work better as teams to provide you the highest quality care possible. They are working to get you the care you need at the time you need it.
Fighting Fraud: The Affordable Care Act builds on our efforts to combat fraud and abuse. These efforts are saving billions of dollars in money that was being stolen from people with Medicare. And thanks to these efforts and other reforms, the life of the Medicare Trust fund will be extended.
Protecting Medicare Benefits: Under the new health reform law, your existing Medicare-covered benefits can’t be reduced or taken away. As always, you will be able to choose your own doctors.
The Affordable Care Act makes it easier for businesses to find better coverage options and builds on the employer-based insurance market already in place. It stops insurance companies from taking advantage of you, giving the consumer and business owner more control and making health care coverage more affordable.
Building on Employer-Based Insurance Market: The average US family and their employer pay $1,000 a year extra in health insurance costs to cover care for the uninsured. By bringing the uninsured into the system and tackling the drivers of health care costs, the new health care law will make health insurance more affordable for businesses.
More Affordable Care: 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. And insurance companies must publicly justify their actions if they want to raise premiums by 10 percent or more for small businesses. And an increasing number of States have more power to block unreasonable premium increases from taking effect.
Common Sense Approach: The new health care law makes improvements to the health insurance system we already have, and gives States significant flexibility to implement the new law in the way that makes sense for their insurance markets. And, the new law does not add a dime to the deficit. According to Congress’s official independent scorekeeper, the Congressional Budget Office, the new law is completely paid for through a wide range of cost-saving reforms, from cracking down on health care fraud to helping hospitals and doctors spend their health dollars more wisely.
For Small Business Owners:
Small Business Tax Credit: Small businesses have historically paid 18 percent more for health coverage than larger employees. Today, a tax credit is available to businesses with 25 or fewer full-time-equivalent employees and average wages of $50,000 or less. To get more details and learn whether you might qualify, you should visit the IRS website.
Finding Insurance Options: For the first time ever, small businesses have access to a new tool that lets them research and compare their health insurance options in one place – HealthCare.gov. Just enter some basic information about your business, and you’ll see a list of all the insurance options available in your area, broken down by how much they cost and what coverage they offer. And starting in 2014, Affordable Insurance Exchanges will make buying health insurance easy. Small business owners will be able to offer their employees a range of plans from different insurers just like big employers do, while still receiving a single bill and writing a single check. They’ll also still be able to choose how much of their employees’ insurance costs they want to cover. And because small business owners will be joining a much bigger risk pool, they’ll no longer be vulnerable to sharp swings in their rates based on the health of a few employees.
The new health care law enacts comprehensive reforms that will hold health insurance companies accountable, protect you and your patients, and guarantee choice and control. It also reduces the burden of uncompensated care on physicians and hospitals by making access to care easier and more affordable than ever.
Ending Insurance Company Abuses: Insurers can no longer cancel coverage when a patient gets sick and set lifetime benefit limits that leave patients without coverage in times of catastrophic need. And if insurers don’t spend at least 80% of premium dollars on patient care and quality improvements, they’ll have to provide a rebate to consumers. These protections will end the worst insurance company abuses and put patients and providers ahead of company profits.
Expanding Access to Coverage: The new law will help reduce the burden of uncompensated care on physicians and hospitals by making access to care easier and more affordable than ever before for all Americans. From allowing young adults to stay on their parent’s plan until age 26 to implementing new Pre-Existing Condition Insurance Plans people locked out of the current insurance market to the Affordable Insurance Exchanges that begin in 2014 to help those who lack choices today get health coverage, the new law will give more Americans the security of affordable health insurance.
Cutting Red Tape: New rules save time and money for physicians and other health care providers by allowing you to spend more time in the exam room, and less on administration.
Opportunities and Incentives to Coordinate Care: The new law created a new Innovation Center in the Centers for Medicare and Medicaid Services –specifically designed to identify and test new care and payment models to deliver greater value for our health system and then to rapidly spread what works. Thanks to input from hundreds of health care providers, we’ve developed a menu of initiatives that engage different types of providers and payers. Each initiative holds the promise of reducing health care costs, improving quality, and improving health care.
Strengthening the Workforce: The new health care law also invests in training and placing thousands of new doctors and nurses, and it provides bonus payments to primary care doctors. The new law is also creating and expanding health centers across the country. As a provider, this will help you see and spend more time with your patients.
If you’re living with a disability, private health insurance may be hard to come by. Even if you can afford to buy it, it probably doesn’t cover all of your needs. Worrying about where to get coverage and the cost of your care is the last thing you want to do. The Affordable Care Act is expanding your options for health insurance and making them more affordable.
Ending Insurance Company Abuses: Thanks to the Affordable Care Act, insurers can no longer put a lifetime cap on how much care they will pay for if you get sick, or cancel your coverage when you make a mistake on your paperwork.
Ending Discrimination against Pre-Existing Conditions: Under the new health care law, plans are no longer allowed to deny or exclude coverage to any child under age 19 based on a pre-existing condition, including a disability. Starting in 2014, these same plans won’t be able to discriminate against anyone with a pre-existing condition.
Expanding Affordable Coverage: If you have been uninsured for six months and can’t buy private insurance because of a pre-existing condition, you can join the Pre-Existing Condition Insurance Plan. To find out about plans available in your State, please visit www.pcip.gov.
New Long-Term and Community-Based Care Options: The new law builds on successful models and provides incentives to States to expand efforts to offer people with disabilities more opportunities to receive the long term supports and services they require in their communities, through programs such as Money Follows the Person and Community First Choice Option.
Take a Closer Look
For more in-depth information on the positive effects of health reform, watch the videos or download one of these PDF reports.
Health Reform for Latinos
Health Reform for African Americans
Secretary of Labor Hilda Solis discusses Health Reform, for Latinos
Reforma de salud para los Latinos. Secretaria de Trabajo Hilda Solis.
Dr. Garth Graham from Office of Minority Health discusses Health Reform and African Americans