The easy-to-understand explanation of what the Affordable Care Act, the national health reform law, means for Wisconsin consumers!

1. The Affordable Care Act
Making health care more secure and
returning control to consumers
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2. STOP!!
Are you watching this online instead of in person? If so, you
are missing out some of the most impressive facts, the best
messages for talking about the law and the opportunity to get
your questions answered in real time!
Invite Citizen Action to speak at your next meeting, we speak at…
•Congregations •Support Groups •Nonprofits •Classrooms
•Businesses •Political meetings •Union Meetings •Senior Centers
•Civic Groups •Professional Associations •House Parties •And more!
Anywhere in Wisconsin, completely free!
Kevin Kane, Healthcare Organizer Back to the
414 550 8280 Presentation…
Kevin.kane@citizenactionwi.org

3. Our Health Care Principles
What guides the work we do:
• Health Care Freedom must be restored.
Medical decisions should be controlled by
patients in consultation with their healthcare
providers, without interference from insurance
companies
• Everyone should have health security, – the
ability to purchase quality coverage at a fair and
affordable price.
• Health Care discrimination by insurance
companies is a violation of fundamental
rights, especially against people with
preexisting conditions, and must be outlawed.
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4. The Affordable Care Act
The new national health care law, achieves
these principles
--Passed March 23, 2010
--Reforms Come in 2 Stages
Happy 2nd
Birthday
ACA!
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5. Stages of Reform
Stage 1 (in effect now)
• Outlaws worst health insurance
abuses including denials based on
preexisting conditions for children
(adults with preexisting conditions will be
covered in 2014).
• Creates new standards for
insurance, such as allowing young
2.5 million young
adults now have adults to stay on parents policies
coverage that
didn’t before! until they are 26. 5

6. Stages of Reform
Stage 2 (goes into effect 2014)
• Expand BadgerCare (Medicaid) to almost
all low income Wisconsinites.
• Create competitive health marketplace to
guarantee coverage to everyone who
does not have good insurance at work.
• Require Members of Congress to buy the
same plans offered to everyone else in
the new marketplace.
• Strengthen Medicare for Seniors.
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7. Stage 1 Reforms
Insurance Practices Outlawed now
under the Affordable Care Act
• Preexisting condition exclusions (kids now/
everyone in 2014)
• Lifetime limits
• Dropping coverage after a person gets sick
The Governor
tried to block• Excessive insurance industry profits and
this for 3 overhead (80-85% of your premium dollars
years, but
was prevented must be spent on medical care, not profits)
from doing so
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8. Stage 1 Reforms
The Affordable Care Act guarantees
• Preventive care coverage (ex:
Mammograms, checkups, etc) with no cost
Get care sooner sharing (co-pays, deductibles, etc)
It saves
Money & lives!• Young adults can stay on parents
policies until age 26
• Preventive care without cost sharing
for seniors on Medicare
Seniors have enjoyed this all of last year 8

9. The Affordable Care Act Ends
Discrimination for 2.5 Million
Wisconsinites Under 65
• Nearly 1 Million in Wisconsin under age
65 have a preexisting conditions that
would deny coverage to them if they
bought insurance on their own
• An additional 1.5 million non-elderly
Wisconsinites have preexisting conditions
that could cause them to be denied
coverage or charged excessive rates.
(Source: U.S. Department of Health & Human Services, January 2011)
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10. Just Some of the Examples of
Preexisting Conditions
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11. The Faces of Reform
How the Affordable Care Act is
already helping people
across Wisconsin who would
otherwise be the victims of
health insurance
discrimination
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12. Sami’s Story
“My 7-year-old son, Sami, suffers from a
disease that causes tumors to grow all
over his body. Sami’s treatments
could not continue if we hit our
insurance policy’s life time limit.
Thanks to the Affordable Care Act,
insurance companies can no longer
impose lifetime limits or deny health
coverage to children like Sami with
preexisting conditions. We can’t go
back to being on our own against the
insurance companies.”
--Tracy, Appleton, Wisconsin
.
Without the Affordable Care Act’s protections, 12
What would this family do?

13. Remy’s Story
“I own a small café. Over 20 years ago
I beat cancer, but ever since then no
insurance company would sell me a
policy because my cancer is called a
preexisting condition. Starting in 2014
under the Affordable Care Act, no
insurance company will be allowed to
discriminate against me because I’m
a cancer survivor.”
--Remy, Pepin, Wisconsin
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14. Stage 2: Guaranteed
Affordable Health Care (2014)
• Wisconsin, with federal funding,
The Governor creates a new competitive health
blocked $38
million to create marketplace, while keeping what
this. We will still
have one, but works now in place.
the Federal
•
Government will The new health marketplace options
now create one
for us instead of are voluntary. If you have good
the state.
coverage through your job you can
keep it.
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15. Competitive Health
Marketplace for Middle Class
• Created by each state to meet unique
needs by 2014.
• Access through website, similar to
Travelocity or Consumer Reports, chose
your own private insurance carrier and
standards benefits plan.
• System voluntary: can stay with current
health insurance if it works for you.
• Consumers in control, with clear
information, clear comparisons, and real
competition. 15

16. Competitive Health
Marketplace
• Makes coverage more secure by ensuring
that people cannot be denied coverage
due to preexisting conditions or have
coverage dropped when they get sick.
• Members of Congress will be required to
get their coverage through the same
competitive marketplace
• Makes coverage more affordable, by
providing tax credits on a sliding scale to
middle class Wisconsinites.
• Offers new options, such as a new
nonprofit insurance cooperative company
• Bans discriminatory pricing based on
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medical condition, age, or gender.

17. Gender Discrimination
• In one of the most glaring inequities, women
are charged more then men by health
insurers.
• This and other kinds of discrimination are
outlawed in the new competitive health
marketplace.
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18. Stabilizes & Expands BadgerCare
to low income Wisconsinites
• BadgerCare expanded to include every
citizen who meets income requirements
• Wisconsin’s contribution of BadgerCare
expansion is substantially reduced.
• Eliminates the risk of BadgerCare cuts.
What is happening
now in Madison re:
• Affects 337,000 Wisconsinites Badger-
kicking tens of
thousands off of
Care (Medicaid) recipients with serious
Badgercare will not
be allowed in 2014
and chronic diseases such as Cancer,
Lung Disease, Diabetes & Heart Disease.
Conditions, that if denials due to preexisting conditions didn’t occur 18
(and in 2014 they won’t), will be able to get health coverage

19. Strengthen Medicare
The Affordable Care Act protects
Medicare benefits for seniors and
strengthens the program for future
generations by
Saved $4
• cracking down on waste, fraud, and
Billion last abuse in Medicare,
year alone!
• ending handouts to insurance
companies, and
• providing free preventive care to
decrease costly emergency room visits
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and reduce health care costs long-term.

20. Faces of Reform
The human impact of the new
competitive health marketplace . . . .
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21. John’s Story
"I have a tooth that is in infected and needs to be
removed, which normally costs $100, but
because I have Hemophilia the drugs are
between $50,000 & $100,000 just to stop the
bleeding. I have been denied insurance because
of my condition, any employer-based care would
require me to wait a year. I have no way of
dealing with my conditions the way things are
now. That is why I am looking forward to the new
health marketplace."
--John, Small Business Owner, Albany, WI
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22. Steve’s Story
"I suffered from a deteriorating spine
problem for about 10 years...We
discovered what so many Americans
have had the misfortune of
discovering-It was impossible to
purchase health insurance on the free
market if you were considered high
risk (had a pre-existing condition)...We
applied many times over the years to
every health insurance company we
could find and were flat out rejected…
with little other option I took a 20 hour
flight to Malaysia to get treatment.
Under the Affordable Care Act, I will
have a right to coverage so I can get
treatment here in the U.S.”
--Steve, Verona, Wisconsin
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23. The Choice
• There will be change: because of
skyrocketing health costs everyone
agrees we need to change.
• One option is to continue implementing
the Affordable Care Act, which is already
protecting us from health discrimination
and will guarantee greater security and
control.
• The second option on the table is the
“Pathway” Budget plan which passed the
U.S. House of Representatives in 2011 &
introduced again in 2012 23

24. Pathway Plan
1. Repeals the Affordable Care Act,
allowing insurance companies to deny
coverage to millions of people with
preexisting conditions and drop
coverage for those who get sick, forcing
many into bankruptcy.
2. Ends Medicare as we know it, and gives
seniors vouchers that will not keep up
with medical inflation, doubling their out-
of-pocket costs.
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25. Pathway Plan
• Cuts $810 billion from Medicaid,
including funding for long term care for
seniors and people with disabilities, and
BadgerCare for children & families.
• Gives $10 trillion in taxpayer funded
subsidies to the health insurance
industry over life of the plan.
• Prevents creation of competitive health
marketplace where everyone who
needs it will have a choice of good
plans and tax credits to afford them. 25

26. The Affordable Care Act is
Worth Protecting
• Guarantees health care freedom.
Working families no longer can be
denied coverage for preexisting
conditions, lose their coverage when
they get sick, or have to haggle with
insurance companies about claims and
crucial medical treatments.
• Everyone will have the peace of mind of
knowing that they and their families
have guaranteed access to affordable
coverage options, no matter what..
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27. Affordable Care Act is Worth
Protecting
• Increased opportunity: families will not
Groups that struggle be forced into bankruptcy when
to get coverage now:
-Entrepreneurs someone gets sick, and will be free to
-Small biz owners
-Farmers pursue economic opportunities without
-Contractors
-Nonprofits
being constrained by health insurance
-Churches access issues.
to name a few
• Wisconsin should work to improve
the new law by implementing it in a way
that works for everyone, not special
interests such as the health insurance
industry. 27

28. How You Can Help
• Real Stories change hearts & minds,
share your health care stories with us!
• Hold a house party and invite us to learn
how to “Talk Health Reform”, or
invite our speaker’s bureau to your next
event!
• We need speakers to present this
presentation to others
• Does your small business need better
insurance? Let us know! 28

29. Questions?
• Kevin Kane
Healthcare Organizer
Citizen Action of Wisconsin
414 550 8280 (cell)
kevin.kane@citizenactionwi.org
facebook.com/got.healthcare
citizenactionwi.org 29