What the Affordable Care Act is doing for Oklahoma families
The Affordable Care Act has already covered one in four uninsured Americans – more than ten million – and improved coverage for virtually everyone with health coverage. Insurers can no longer discriminate against preexisting conditions, charge women more just for being women, or put caps on the care you receive. Hospitals, doctors and other providers are changing the way they operate to deliver better care at lower cost. In the years to come, the ability to buy portable and affordable plans on a competitive marketplace will allow countless Americans to move, start businesses, and dream big American dreams -- without worrying if an illness will bankrupt them. Here is how the Affordable Care Act is working for families in Oklahoma:
After Health Reform: Improved Access to Care
· Gallup recently estimated that the uninsured rate in Oklahoma in 2014 was 18.5 percent, down from 21.4 percent in 2013.
· Prohibits coverage denials and reduced benefits, protecting as many as 1,578,794 Oklahomans who have some type of pre-existing health condition, including 218,356 children.
· Eliminates lifetime and annual limits on insurance coverage and establishes annual limits on out-of-pocket spending on essential health benefits, benefiting 1,197,000 people in Oklahoma, including 450,000 women and 317,000 children.
· Expands Medicaid to all non-eligible adults with incomes under 133% of the federal poverty level. If Oklahoma expands Medicaid, an additional 127,000 uninsured people would gain coverage.
· Establishes a system of state and federal health insurance exchanges, or marketplaces, to make it easier for individuals and small-business employees to purchase health plans at affordable prices through which 106,392 people in Oklahoma were covered in March 2015.
· Created a temporary high-risk pool program to cover uninsured people with pre-existing conditions prior to 2014 reforms which helped more than 1,030 people in Oklahoma.
· Creates health plan disclosure requirements and simple, standardized summaries so 1,880,900 people in Oklahoma can better understand coverage information and compare benefits.
After Health Reform: More Affordable Care
· Creates a tax credit to help 87,136 people in Oklahoma who otherwise cannot afford it purchase health coverage through health insurance marketplaces.
· Requires health insurers 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, 89,648 consumers in Oklahoma received $6,739,649 in rebates.
· Eliminates out-of-pocket costs 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 1,556,695 people in Oklahoma including 627,152 women.· Eliminates out-of-pocket costs for 463,198 Medicare beneficiaries in Oklahoma for preventive services like cancer screenings, bone-mass measurements, annual physicals, and smoking cessation.
· Phases out the “donut hole” coverage gap for 65,159 Medicare prescription drug beneficiaries in Oklahoma, who have saved an average of $925 per beneficiary.
· Creates Accountable Care Organizations consisting of doctors and other health-care providers who share in savings from keeping patients well while improving quality, helping 53,397 Medicare beneficiaries in Oklahoma.
· Phases out overpayments through the Medicare Advantage system, while requiring Medicare Advantage plans to spend at least 85 percent of Medicare revenue on patient care. Medicare Advantage enrollment has grown by 28,300 to 112,477 in Oklahoma since 2009.
After Health Reform: Improved Quality and Accountability to You
· Provides incentives to hospitals in Medicare to reduce hospital-acquired infections and avoidable readmissions. Creates a collaborative health-safety learning network, the Partnership for Patients, that includes 81 hospitals in Oklahoma to promote best quality practices.
We're not done. Other legislation and executive actions are continuing to advance the cause of effective, accountable and affordable health care.
This includes:
· Incentive payments for doctors, hospitals, and other providers to adopt and use certified electronic health records (EHR). In Oklahoma more than 47.3 percent of hospitals and 36.9 percent of providers have electronic health records systems.
· A new funding pool for Community Health Centers to build, expand and operate health-care facilities in underserved communities. Health Center grantees in Oklahoma now serve 162,871 patients and received $94,966,095 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, 2014, there were 167 Corps clinicians providing primary care services in Oklahoma, compared to 31 clinicians in 2008.