Pozitive Health Care Reform

Transcription

1 Pozitive Health Care Reform Revolutionizing the Health of Our Community AIDS Foundation of Chicago

2 The role of AIDS organizations in health care reform Our mission Our responsibility Our fight Our chance to completely change (for the better!) the landscape for prevention, treatment, care, and essential services for people living with HIV

3 Of all the forms of inequality, injustice in health care is the most shocking and inhumane. -Martin Luther King, Jr.

4 The Need Nearly half of the 1.1 million PLWHA lack access to health care Only 17% of PLWHA in the U.S. are covered by private insurance Current patchwork of HIV/AIDS programs and services leaves too many people behind Insurance companies lawfully discriminate against PLWHA and millions of others with health- service needs Most PLWHA are poor, but not poor enough for government health insurance such as Medicaid In total, 47 million people in the U.S. lack health insurance coverage and millions more have inadequate coverage

5 Health Care Reform Will Fight AIDS Comprehensive HCR could rapidly accelerate efforts to end the epidemic by covering most PLWHA and helping reduce new HIV infections For PLWHA, HCR would increase access to consistent, high-quality, affordable, and comprehensive care for HIV and other health concerns With better health access, life expectancy for PLWHA would vastly improved

6 Health Care Reform Will Fight AIDS With better health access, less time and resources would be expended helping PLWHA navigate the limited and complicated patchwork system of health programs Current patchwork system of HIV/AIDS programs and services leaves too many people behind

7 Architecture of Reform: Build on What We Have Expand Medicaid to cover all lowincome: Medicaid is a state-federal insurance program targeted mainly at low-income children, pregnant women and disabled people (some 44 million are now covered). Legislative proposals would expand Medicaid to all low-income people including childless adults. Some 11 million more could be covered. Private coverage: New regulations will help the 167 million Americans with employerbased and individual coverage keep and afford their insurance Middle class uninsured: With a combination of strategies (insurance reform, mandates, subsides, and exchanges), the government would help the million middleincome Americans purchase coverage Make Medicare more affordable: Medicare is the nation s health insurance program for some 38 million retirees and disabled workers. Legislative proposals would help beneficiaries afford their medications by lowering out-of-pocket expenses.

8 Understanding the Debate Congressional proposals address the following concepts: Regulating the sale of insurance products Increasing access to Medicaid for lowincome people Requiring most people and companies to purchase coverage for themselves or their employees or face financial penalties

9 Understanding the Debate Establishing insurance exchanges, which are marketplaces of insurance plans available for individuals and companies to purchase Government subsidies for middle-income people to help make insurance more affordable Changes to Medicare to help retirees and disabled workers Other provisions to spur healthcare innovation, promote preventative care, and address racial/ethnic health disparities

10 A Public Option: What It is and Why It s Important for People with HIV/AIDS If approved, one of the plans offered in the insurance exchange would be sponsored by the federal government to compete alongside private plans for prospective customers. Medicare and the Veteran Administration are two examples of public plans. Inclusion of a public plan would: Help eliminate geographic disparities in health care by guaranteeing access to a high-quality plan in each area

11 A Public Option: What is It and Why It s Important for People with HIV/AIDS Provide care with a low overhead and administrative costs Not be government subsidized but would pay for care with the premiums and copayments it collects Would help contain cost for all plans Would likely offer people with disabilities undesirable customers for the for-profit plans a high-quality options catering to their needs

12 Why Co-ops Won t Work Some opponents of a public option support member-owned cooperatives. This model is: Untested Unlikely to create the competition necessary to drive down cost Most likely to be outsourced to insurance companies Offers a weak structure and financing that could require government subsidies to function Doesn t have an infrastructure or network to build upon will be starting from scratch

13 What HCR means for Ryan White Advocating for HCR is not advocating against RW Efforts to protect and improve Ryan White must continue Health care reform doesn t eliminate the need for Ryan White HCR won t address the specialized needs that RW services help meet BUT, it will allow poz folks to access health care services beyond what RW provides Non-citizens with HIV will still need to rely on Ryan White for services

14 Congress and White House generally support Ending discrimination against pre-existing conditions Limiting premium discrimination based on gender, health condition Preventing insurance companies from dropping coverage when a person gets sick and needs it most

15 Congress and White House generally support Eliminating extra charges for preventative care like mammograms, flu shots, diabetes tests Creating new insurance marketplace the Exchange that allows people to buy insurance at competitive prices Providing tax credits to help people buy insurance

16 Lawmaking Process Senate Health, Education, Labor, and Pensions Committee (HELP) chaired by Sen. Tom Harkin (D-IA) Finance Committee chaired by Sen. Max Baucus (D- MT) Conference negotiations A single bill must pass in both chambers House Ways & Means Committee chaired by Rep. Charles Rangel (D-CA) Education & Labor chaired by Rep. George Miller (D-CA) Energy & Commerce chaired by Rep. Henry Waxman (D-CA) White House Signs into law Implements

17 Component House Bill The Bill Sen. HELP Breakdown Bill Sen. Finance Bill Medicaid 133% of FPL Includes childless adults 133% FPL Includes childless adults Medicare Closes donut hole Cuts donut hole by 50% Mandates Individuals & companies, exceptions for some small businesses Individuals & companies, exceptions for some small businesses Most U.S. citizens & legal residents, employer requirements linked to subsidies Exchange National State-based State-based Public Option National State-based Subsidies % of FPL % FPL % of FPL Public Health & Wellness Develops national prev/health strategy Eliminate cost sharing for prev. in Medicare Develops national prev/health strategy Grants to public health and CBOs Expands prevention through Medicare & Medicaid HIV Provisions Extends Medicaid coverage to HIV+ Counts ADAP as TrOOP

18 What We Are Asking for A Public Insurance Option to control costs long-term and ensure everyone has access to a high-quality plan no matter where they live Expansion of Medicaid coverage to all low-income individuals, including childless adults Establishment of standard, comprehensive Medicaid benefits package Affordability of private health insurance Establishment of a Prevention and Public Health Investment Fund

19 Where We Are At House Senate HELP Senate Finance

20 Don t Believe The Hype Media is depicting a lost battle It ain t so! Progressive Caucus is rallying for a strong plan Comprehensive health care reform is possible All hands and voices are needed on deck YES that means yours too

21 We Are Part of A Movement Advocates for every kind of person and community are working to make this human right a reality: HIV, women, people of color, LGBTI, unions, seniors, chronic diseases, youth, progressives, small businesses, poor folk, middle class folk, immigrants, people with disabilities

22 Here s How YOU Can Help Take action on all AFC alerts Forward them to your personal and professional networks Post them to Facebook Announce that you have just taken action and urge friends to do the same Collect petitions at Saturday s Run/Walk Volunteer to phone bank with AFC Every Wednesday 5:30-8:30pm

23 Your Turn Questions? Concerns? Comments?