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The Benefits of Health Reform In Florida

TALLAHASSEE – Together, the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act will ensure that all Floridians have access to quality, affordable health insurance.

The Congressional Budget Office has determined that these two bills are fully paid for, will bend the health care cost curve, and will reduce the deficit by $143 billion over the next ten years with further deficit reduction in the following decade.

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act will reduce the cost of health care for the middle class, ensure health security to seniors, and provide tax credits to small businesses and individuals to further reduce the cost of health coverage.

Key Benefits for Florida
  • Provide tax credits for up to 216,000 Florida small businesses to help make coverage more affordable. [HealthReform.gov, accessed 3/20/10]
  • Prohibit insurance companies from excluding coverage of pre-existing conditions for the 4.1 million children in Florida, starting this year. [U.S. Census Bureau, 1/7/10]
  • Close the “donut hole‟ and improve other Medicare benefits for 3.2 million Florida seniors. [HealthReform.gov, accessed 3/20/10]
  • Reduce Medicare premiums for the 2.3 million Florida seniors who are not enrolled in Medicare Advantage and will no longer subsidize these private insurance plans. [Senate Finance Committee]
  • Ensure affordable coverage options for 4 million Floridians who are uninsured and 1.1 million Floridians who purchase health insurance through the individual market. [HealthReform.gov, accessed 3/20/10]
  • Ensure immediate access to affordable insurance options for as many as 464,791 uninsured Floridians who have a pre-existing condition. [staff estimate using Agency for Healthcare Research and Quality (AHRQ), 4/09 and HealthReform.gov, accessed 3/20/10]

o Provide tax credits for up to 2.5 million Floridians to help make health insurance more affordable, bringing $40.9 billion in premium and cost-sharing tax credits into Florida during the first five years of the health insurance Exchange. [HealthReform.gov, accessed 3/20/10; Senate Finance Committee]

o Reduce family health insurance premiums by $1,560 – $2,240 for the same benefits, as compared to what they would be without health reform by 2016. [Senate Finance Committee estimate based on CBO, 11/30/09]

o Provide access to Medicaid for 1.2 million newly-eligible Floridians, and provide $19.8 billion in federal funding for the cost of their coverage. [Urban Institute, 1/25/10; Senate Finance Committee]

– Create 14,900 – 23,800 jobs by reducing health care costs for employers. [U.S. Public Interest Research Group, 1/20/10]

– Allow 1.6 million young adults to stay on their parents‟ insurance plans. [U.S. Census Bureau, 1/7/10]

– Provide more federal funding for 372 Community Health Centers in Florida. [National Association of Community Health Centers, 2009]

Affordable Coverage Options for Florida Small Businesses

Small businesses make up 75.9 percent of all Florida businesses, yet just 42 percent of these small businesses are able to offer health insurance to their employees. [AHRQ, accessed 3/20/10; AHRQ, accessed 3/20/10]

Starting this year, up to 216,000 Florida small businesses will be eligible for tax credits for a percentage of their contribution to their employees‟ health insurance. [HealthReform.gov, accessed 3/20/10]

Small businesses of the size that qualify for these tax credits employ 1.1 million Floridians. [AHRQ, accessed 3/20/10]

Protecting Children

Recognizing the special vulnerability of children, health reform prohibits insurance companies from excluding coverage of pre-existing conditions for the 4.1 million children in Florida. This takes effect six months after enactment and applies to all new plans. [U.S. Census Bureau, 1/7/10]

Strengthening Medicare for Florida Seniors

Health reform improves Medicare benefits for the 3.2 million Medicare beneficiaries in Florida. [HealthReform.gov, accessed 3/20/10] Each year, 565,000 Florida seniors hit the Medicare Part D „donut hole.‟ [HealthReform.gov, accessed 3/20/10] Starting this year, seniors who hit this gap in their prescription drug coverage will receive a $250 check, and the „donut hole‟ will be completely closed by 2020.

The 3.2 million Medicare beneficiaries in Florida will see other improvements to the program, including a free, annual wellness visit and no cost-sharing for prevention services. So, you may be asking yourself is Medicare Advantage right for you?

Finally, by gradually moving to a more fair payment system for private insurance companies who participate in Medicare Advantage, health reform will lower Medicare costs for the 2.3 million Florida seniors not enrolled in Medicare Advantage, by as much as $45 in premium costs each year. [Senate Finance Committee]

Affordable Coverage Options for Floridians

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act contain several provisions to expand affordable coverage options for millions of Americans. First, health reform will provide immediate access to quality, affordable health insurance for as many as 464,791 uninsured Floridians who are unable to obtain health insurance because of a pre-existing condition. [staff estimate using AHRQ, 4/09 and HealthReform.gov, accessed 3/20/10] This new $5 billion program will take effect 90 days after enactment of health reform.

Second, health reform will ensure that the 4 million uninsured Floridians and 1.1 million Floridians who purchase health insurance through the individual market have access to affordable health insurance options through state-based health insurance Exchanges. [HealthReform.gov, accessed 3/20/10]

By reforming the insurance market and forcing insurance companies to compete for business through the Exchange, health reform will reduce family health insurance premiums by $1,560 – $2,240 for the same benefits. [Senate Finance Committee estimate based on CBO, 11/30/09]

In addition, 2.5 million Floridians will receive premium tax credits to help make health insurance even more affordable. [HealthReform.gov, accessed 3/20/10] During the first five years that the health insurance Exchange is operational, Floridians will receive $40.9 billion in premium and cost-sharing tax credits to further reduce the cost of health insurance. [Senate Finance Committee]

Finally, health reform will open access to Medicaid for 1.2 million newly eligible Floridians, by expanding eligibility to non-elderly parents, childless adults, children and pregnant women with income up to 133 percent of the federal poverty level. [Urban Institute, 1/25/10]

The federal government will fully fund the cost of covering these newly eligible individuals for three years and will pay 90 percent of these costs after 2020, compared to the current contribution in Florida of 55 percent of costs.

In total, Florida could receive $19.8 billion in federal funding during just the first five years of this coverage expansion. [Senate Finance Committee]

Affordable Coverage Options for Florida Young Adults

According to the National Conference of State Legislatures, “Young adults often lose their health insurance if covered under a parent‟s or guardian‟s policy at age 19 or upon graduation from high school or college.” [NCSL, accessed 3/20/10]

Starting this year, 1.6 million young adults in Florida will be able to remain covered by their parent‟s insurance policy until age 26. [U.S. Census Bureau, 1/7/10]

In addition, once the health insurance Exchanges are operational in 2014, 2,572,685 Floridians under age 30 will have access to less costly catastrophic-only health insurance plans. [U.S. Census Bureau, 1/7/10]

These plans will also be available to others who are exempt from the individual responsibility policy.

Job Creation

A recent analysis found that slowing the growth rate of health care costs will make it more profitable for businesses to expand employment, leading to estimated job gains nationwide of 250,000 – 400,000 per year for the next decade as a result of health reform. [Center for American Progress, 1/10] For Florida, this could mean 14,900 – 23,800 new jobs each year. [U.S. Public Interest Research Group, 1/20/10]

Support for Florida Community Health Centers

Community health centers provide critical health care to Floridians, regardless of their ability to pay. Health reform makes an immediate and substantial investment in the 372 federally-funded health centers in Florida. [National Association of Community Health Centers, 2009]

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