The Affordable Care Act:

What does it mean for your Business?

September 13, 2012 Series 4 of 4

Acronyms
ACA AI/AN FPL IHCIA I/T/U Affordable Care Act American Indian/Alaska Native Federal Poverty Level Indian Health Care Improvement Act Indian Health Services, Tribal and Urban Indian organization programs/providers CHIP Childrens Health Insurance Program

Basic Health Insurance Terms

Premium: The amount paid to an insurance company, usually on a monthly basis, for health insurance coverage.

Out-of-pocket costs: Health care costs paid by the patient. These include copayments, coinsurance, and deductibles.
Deductible: A specific dollar amount paid by the user each year before your health insurance plan starts to make payments for a claim. Not all health insurance plans require a deductible. Exclusions: Things not covered by the health insurance policy. Make sure to check the fine print of the health insurance policy for which conditions are excluded.

Basic Health Insurance Terms cont.

Benefit: Any service or supply (an office visit or a prescription drug) your health insurance plan will pay for. Co-payment (copay): The dollar amount paid for a medical service or supply according to your insurance plan. ($20 for sick visit) Pre-existing condition: A health problem or diagnosis that you had before applying for health insurance or before the effective date of your new health plan. By 2014, companies will be unable to deny you coverage based on pre-existing conditions. Lifetime maximum: Refers to the amount of money the health insurance policy will pay for the entire life plan.

The Health Care Law

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (ACA) The ACA protects the right of all Americans, including American Indians and Alaska Natives, to access affordable health care
More than 32 million in this country who would otherwise not have health insurance will have access to health coverage

Recent Supreme Court Decision

On June 28, 2012 the Court upheld minimum coverage requirement Precluded Medicaid expansion requirement Protected IHCIA and implementation efforts to date

The Federal Trust Responsibility

The ACA fulfills the federal trust relationship and strengthens tribal sovereignty through: o Protection of the IHS system o Providing equal access to quality care o Expansion of tribal governments role in health care decisions

ACA Benefits Tribal Governments and Citizens

o Permanent reauthorization of the IHCIA o Strengthens the Indian Health Services system authorities o Greater access to health insurance coverage

Are All Tribal Employers Required to Purchase Insurance?

Small businesses
(less than 50 employees)

Large businesses
(more than 50 employees)

Self Employed

What Does the ACA Mean for Small Businesses?

New tax credits for small businesses (less than 25) Greater purchasing power

Healthier employees

Protection for Small Businesses

Health Insurance Exchanges Cost savings, no matter your employees health status Coverage cannot be cancelled

Federal Employees Health Benefits

Tribes can enroll now FEHB expands options for tribal employees FEHB covers nearly all employees

Why Purchase Insurance?

More competitive benefits and hiring opportunities Cost savings

Healthier employees

What ACA Means for Employers

1. Decrease cost of health insurance coverage 2. New opportunities to purchase health insurance

3. Greater insurance coverage protection

4. Levels the playing field

5. Healthier Employees

Learn More At
http://www.tribalhealthcare.org http://www.HealthCare.gov

http://www.IHS.gov

National Indian Health Outreach & Education (NIHOE) Initiative

NIHOE National Partners

* With generous support from the Indian Health Service

13 NIHOE Area Coordinators

National Congress of American Indians Terra Branson- Legislative Associate Tbranson@NCAI.org