Obama Administration Regional Director in Health and Human Services, Marguerite Salazar, was in Denver Monday to discuss the Affordable Care Act (ACA, or “Obamacare”) and what it means for people living in Colorado. Hosted by Senator Mark Udall, she held a press conference with the Colorado Consumer Health Initiative’s Executive Director, Dede De Percin. Salazar applauded the recent Supreme Court Decision to uphold the Constitutionality of the ACA, and promised it will bring a multitude of benefits to Colorado’s citizens, and to our local economy.
As Udall introduced Salazar, a native of Alamosa, he added he “proudly voted for the Affordable Care Act”, and shared that in his travels around Colorado, many citizens had expressed frustration over their lack of quality healthcare insurance due to pre-existing conditions clauses, as well as caps on coverage.
“Those problems will be gone under the Affordable Care Act. In addition, families like my own with young adults in them will benefit from the feature that ensures people ages 22-26 will still be able to join their parent’s health insurance plans while getting their careers off the ground.”Salazar outlined the scope of the problem in Colorado:
“Until now, there have been 700,000 people uninsured in Colorado. Over the last ten years, insurance rated had doubled. Nationally, more than 50 million Americans were uninsured, and tens of millions of people were underinsured”.
No More Abuses, Better Care for Colorado
The Supreme Court decision to uphold the Affordable Care Act means Coloradans will be protected from insurance company abuses, Medicare will be strengthened, families will experience more financial security, and Coloradans across the state will have better access to healthcare overall.
Under the ACA, it is illegal for insurance companies to deny anyone for pre-existing conditions, to provide coverage caps to families or individuals who experience major medical tragedies, to discriminate against girls and women on the basis of their gender, and to cancel policies after a person has been diagnosed with a chronic illness or disease.
Many Coloradans will receive cash back from their insurance companies if the insurance companies fail to provide enough coverage in proportion to the rates they are charging in premiums. (An older man at the press conference stated he had already received a rebate check for more than $260.) The rebate is called the “80/20 rule” – insurance companies are mandated to spend eighty percent of the payments they collect on health care for their policy holders. If they don’t, they must refund it to their contracted customers. In 2012, 12.8 million Americans will receive more than 1 billion dollars in rebates. The ACA also prevents unfair rate increases -- premium rate hikes greater than 10% will automatically trigger an audit.
Better for Small Businesses, Better for Non-profits
The Affordable Care Act will make doing business in Colorado more affordable. Small businesses, as well as non-profits, which make up 96% of the employing businesses in Colorado, used to pay 18% more in premiums for the same coverage compared to large corporations. Small businesses that choose to provide health insurance premiums for their employees will receive tax credits of 25% to help them do it. In 2011, 360,000 employers received a tax credit nationally. Any small business in Colorado that was not aware of this benefit can go back as far as 2010 to amend their tax return to qualify for their credit. Non-profit businesses (including many churches) that do not pay taxes are still eligible for the credit, allowing them to receive cash payments for providing healthcare insurance to their employees.
Young People Will Be Insured
Families with young adult children in Colorado are already enjoying the “22-26 feature” of the Affordable Care Act. Previously, premiums were too high for young adults just starting out on their own, so many of them were uninsured, putting them at long-lasting financial risk if they had an accident or debilitating illness. Under the ACA, more than 50,000 families in Colorado are already enjoying peace of mind from this benefit. Nationally, the number is 3.1 million families.
Access to Health Care
As Udall traveled Colorado, he saw first-hand how rural areas are often underserved medically. Physicians and other health care providers have preferred doing business in large, urban areas over smaller, rural communities. Under the Affordable Care Act, the number of healthcare providers employed through the National Health Services Corps has tripled, adding 6000 new providers. The NHSC now has more than 10,000 doctors, nurses, physical therapists, dentists, etc., on its’ staff. Since 2010, Colorado has received $17 million from the ACA to fund 170 existing health centers in CO, and $78.8 million to create new health centers.
Preventing Illnesses and Promoting Health
Since 2010, Colorado has received $17.2 million in grants from the Prevention and Public Health Fund created by the ACA. Free, routine health maintenance and preventative services are available through at “Getting Us Covered.” Services include:
• Adult routine examinations
• Smoking cessation programs and patches
• Pelvic exams
• Pap smears
• Prostate exams
• Flu shots
No More “Lockouts” or Caps
Families and individuals facing major medical tragedies and chronic illnesses such as cancer will no longer be “locked out” of health insurance. Nationally, 67,500 people were locked out of the insurance market because their expenses were too high, causing them to be rejected for insurance. In Colorado, families like Nathan and Sonji Wilkes and their young son Thomas finally have access to the life-saving medical care, under the ACA.
Medicare is strengthened under the Affordable Care Act, meaning more recipients will benefit from preventative care, while efficiencies will bring down costs, saving the government more money. Fewer people will use expensive emergency room visits for routine care.
Donut Hole To Close
For Senior Coloradans in the “Donut Hole” – the income bracket where they do not qualify for Medicare prescription coverage, yet they also cannot afford paying for their own prescriptions, the ACA offers a 50% discount on brand-named drugs. In the first five months of 2012, more than 7000 people in Colorado used this benefit, resulting in an average benefit of nearly $700 per person. In addition, more than 42,000 Colorado Seniors have already received a $250 rebate check to help cover the cost of their prescriptions. The donut hole will be closed by the year 2020 under the plan. 5.2 million Senior Citizens have already saved a total of 3.7 billion dollars.
How is the Affordable Care Act paid for?
The cost savings of efficiencies built into the ACA nationally will cover the cost of the Affordable Care Act. Those efficiencies include the addition of new anti-fraud measures, and the strengthening of enforcement to anti-fraud measures that already exist. Health service providers will also be given tools to help them cut costs to patient care. Under the ACA, patients will receive fewer unnecessary and repetitive tests, and more access to preventative education and well-checks.
The Affordable Care Act sets up a system of private sector “Health Exchanges” to make health insurance more affordable to those who do not get it through their employers, or for people who wish to supplement their coverage (the exchanges are not to be confused with a government run-program like Medicare). The Health Exchanges in the ACA utilize and encourage private businesses, allowing them to flourish locally, providing more jobs. Beginning in 2014, Coloradans will be able to purchase their insurance directly through these exchanges. Under the law, the exchanges will not be allowed to discriminate against anyone on the basis of gender of pre-existing conditions. Under Colorado law, tax credits will be available to those who wish to buy their own insurance.
Colorado was originally given a grant of $1 million to plan for the improved health insurance marketplace, and then received a $17.9 million grant to build it. Coloradans can expect it to be launched to the general public sometime in late 2013 or early 2014.
Myths, Lies and Distortions
Religious organizations will not have to provide, endorse, or subsidize the delivery of contraceptives, contraceptive counseling, or abortions, to qualify for the tax credit.
Exorbitant Capital gains taxes have not been built into the Affordable Health Care Act. There is a small feature that affects a very tiny percentage of Americans. Under the ACA, if a couple making more than $250,000/year sells a home and makes a profit in excess of $100,000 on the sale, there is an approximately 3% tax on the gains over $100,000. The resulting small tax increase affects a small fraction of one percent of Coloradans in any given year.
Future Changes to the Affordable Care Act
Senator Udall commented that the Affordable Care Act “is not perfect” but it is a great start to raising the bar in quality health care. When asked, he said he would like to see continuing innovations in alternatives in health care, at times quoting T.R. Reid’s book, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care.
Udall: “Healthcare is a human right. … The Supreme Court decision to uphold the Affordable Care Act was the right one. If the United States is going to lead the world in the twenty-first century, we need to continue to have the best health care in the world. “