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星期三, 3月 02, 2016

The Affordable Care Act: Healthy Communities Six Years Later

FACT SHEET: The Affordable Care Act: Healthy Communities Six Years Later

President Obama promised that he would make quality, affordable health care not a privilege, but a right. After nearly 100 years of talk and decades of trying by presidents of both parties, that’s exactly what he did.

On March 23, 2010, President Obama signed the Affordable Care Act (ACA) into law, putting in place comprehensive reforms that improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices. Today, the ACA is working: thanks to the ACA, 17.6 million previously uninsured people had gained coverage prior to this year’s open enrollment period, and the law has driven the uninsured rate below 10 percent – for the first time since we started keeping records. The ability to buy portable and affordable plans on a competitive marketplace is giving Americans the freedom to move, start businesses and dream big American dreams, which is especially important as more consumers become entrepreneurs. And thanks in part to the law’s focus on reducing costs and inefficiencies, health care prices have risen at the slowest rate in 50 years since the law passed, which will benefit all of us for years to come.

These access gains are due in large part to the efforts of local and state elected officials, community organizations and leaders, and volunteers who have worked tirelessly to help their neighbors find access to quality, affordable coverage. During the most recent open enrollment period from November 1 through January 31, the Administration and its partners on the ground nationwide undertook an unprecedented local and regional effort to sign up the remaining uninsured who are eligible for Marketplace coverage.

As part of this effort, the White House launched its “Healthy Communities Challenge” to engage 20 key communities with large numbers or high percentages of uninsured in states across the country where strong federal, state, and community collaboration can have a meaningful impact on reaching the uninsured. Last month, the White House announced that the winner of the challenge is Milwaukee, Wisconsin. Under the leadership of Mayor Tom Barrett and County Executive Chris Abele, about 38,000 people in the Milwaukee area newly selected a plan through the Health Insurance Marketplace during this open enrollment period. Together with returning Marketplace consumers, about 89,000 people in the Milwaukee area selected a 2016 Marketplace plan. Nationwide, nearly 13 million Americans signed up for 2016 Marketplace coverage, including people who were previously uninsured, as well as Americans finding coverage as they go through changes in life such as being in between jobs or aging off their parents' plans.

Ahead of the upcoming sixth anniversary of the ACA, tomorrow President Obama will travel to Milwaukee to celebrate the city’s victory and discuss how Americans in communities across the country are benefitting from the law. The President will deliver remarks at the Bruce-Guadalupe Middle School on the campus of the United Community Center, which is a part of the Milwaukee Latino Health Coalition and has hosted ACA outreach efforts. The President will also sit down for a conversation with local residents who have written him about the impact of the law on themselves and their families.

Because of the Affordable Care Act, This is What Health Care in America Looks Like Today:
·         17.6 million consumers have gained health insurance thanks to the ACA, prior to this year’s open enrollment period.  From 2010 through the first nine months of 2015, the uninsured rate has fallen by more than 40 percent and, for the first time ever, more than9 in 10 Americans now have health insurance. In Wisconsin, Gallup recently estimated that the adult uninsured rate in 2015 was5.9 percent, down from 11.7 percent in 2013.

·         As many as 129 million Americans who have some type of pre-existing health condition, including up to 19 million children, are now protected from coverage denials and reduced benefits – practices that were routine before the law’s enactment.

·         105 million Americans, including 39.5 million women and nearly 28 million children, have benefited from annual limits on out-of-pocket spending on essential health benefits – and the elimination of lifetime and annual limits on insurance coverage. These are protections that did not exist before the ACA.

·         Americans now have access to critical preventive services at no cost, like flu shots, yearly check-ups, and birth control. These are benefits that did not exist before the ACA.

·         Over 14 million more Americans have received coverage through Medicaid since the ACA’s first open enrollment period in 2013. States have an option to expand Medicaid to all non-eligible adults with incomes under 133 percent of the federal poverty level, and to date, 31 states and the District of Columbia have chosen to expand the program.  In these states that have already expanded Medicaid, 4.4 million uninsured people will gain coverage.  If the remaining states expand Medicaid, over 4 million more uninsured people would gain coverage.

·         The ACA has provided new transparency in how health insurance plans disclose reasons for premium increases and requires simple, standardized summaries so over 170 million Americans can better understand their coverage information and compare plans. These consumer protections did not exist six years ago.

·         2.3 million young Americans gained coverage between 2010 and October 2013 because they could now stay covered on their parents’ health care plans until they turn 26 – a benefit that did not exist before the law.

·         The ACA created tax credits that, as of September 2015, have helped 7.8 million Americans who otherwise often could not afford it purchase health coverage through the Health Insurance Marketplaces.

·         Health insurers are now required to provide consumers with rebates if the amount they spend on health benefits and quality of care, as opposed to advertising and marketing, is too low.  Last year, 5.5 million consumers received nearly $470 million in rebates.  Since this requirement was put in place in 2011 through 2014, more than $2.4 billion in total refunds will have been paid to consumers.

·         Out-of-pocket costs have been eliminated for preventive services like immunizations, certain cancer screenings, contraception, reproductive counseling, obesity screening, and behavioral assessments for children. This coverage is guaranteed for more than 137 million Americans, including 55 million women.

·         Out-of-pocket costs have been eliminated for 39 million Medicare beneficiaries for preventive services like cancer screenings, bone-mass measurements, annual physicals, and smoking cessation.

·         The ACA expands mental health and substance use disorder benefits and parity protections to over 60 million Americans.

·         The ACA phases out the “donut hole” coverage gap for nearly 10.7 million Medicare prescription drug beneficiaries, who have saved an average of $1,945 per beneficiary. 

·         Accountable Care Organizations now exist, consisting of doctors and other health-care providers who come together to provide coordinated, high-quality care at lower costs to their Medicare patients. Over 477 ACOs are serving nearly 8.9 million Medicare beneficiaries nationwide.

·         Overpayments through the Medicare Advantage system have been phased out, while Medicare Advantage plans are required to spend at least 85 percent of Medicare revenue on patient care.  Medicare Advantage enrollment has grown by 50 percent to over 17.1 million while premiums have dropped by 10 percent since 2009.

·         Hospitals in Medicare now receive incentives to reduce hospital-acquired infections and avoidable readmissions.  A collaborative health-safety learning network, the Partnership for Patients, includes more than 3,200 hospitals to promote best quality practices. 

In addition, other legislation and executive actions are allowing us to continue to build on this progress and advance the cause of effective, affordable and accountable health care. This includes:

·         Advancing innovative care delivery models and value-based payments in Medicare and Medicaid.  The Administration set ambitious goals of tying 30 percent of traditional Medicare payments to alternative payment models by the end of 2016 and 50 percent by the end of 2018.  
·         Proposals to invest in targeted research and technologies to advance the BRAIN InitiativePrecision Medicine Initiative, and cancer research.
·         A funding pool for Community Health Centers to build, expand and operate health-care facilities in underserved communities.  Health Center grantees served 23 million patients in 2014 and received $11 billion under the health care law to offer a broader array of primary care services, extend their hours of operations, hire more providers, and renovate or build new clinical spaces.

·         Health provider training opportunities, with an emphasis on primary care, including a significant expansion of the National Health Service Corps.  As of September 30, 2015, there were 9,600 Corps clinicians providing primary care services, compared to 3,600 clinicians in 2008.