This section includes materials that discuss specific aspects of the new law, as well as resources designed to help advocates talk about the positve effects that the health care law will have on their communities. See also Implementing the New Law for resources that will help advocates prepare for implementation.
General Information on the New Law
Eight Myths about the Affordable Care Act sets the record straight on common misconceptions about the new law. (August 2012)
Hidden Treasures in the Affordable Care Act is a series of seven fact sheets that explores some of the lesser-known benefits in the health care law that will be lost if it is struck down or repealed. (June 2012)
The Bottom Line: How the Affordable Care Act Helps America's Families shows the net financial effects of the Affordable Care Act on family budgets. We found that lower- and middle-income families, both uninsured and insured, will be financial winners. | State Reports (October 2011)
To Build a Strong Affordable Care Act, Protect Medicaid explains that Medicaid is the foundation for health reform and briefly discusses the proposals that could damage Medicaid. Those working to implement health reform need to understand how threats to Medicaid could undermine their work. (September 2011)
Sharing Across the States: Strategies for Public Education is a guide for state advocates about how to educate the public about the new health care law. This guide discusses community forums and Train-the-Trainer programs and gives examples of how state groups across the country have used these public education models to get information to their communities. (September 2010)
In this video, "Modern Healthcare" Managing Editor Neil McLaughlin discusses the impact of the Patient Protection and Affordable Care Act with Ron Pollack, who argues that the more patients and providers know about specific aspects of the law, the more favorably they view it. (July 26, 2010)
How Health Reform Helps the States are state-specific one-page fact sheets that look at the many benefits that health reform will bring to each state, including cracking down on insurance company abuses, ending runaway premiums, and providing financial security. (May 2010)
Help Is on the Way: 12 Reasons to Embrace Health Reform discusses key improvements in the new health reform law, including clamping down on insurance company abuses, offering tax credits to small businesses, expanding Medicaid, and improving Medicare. (May 2010)
Efforts to Halt Health Reform: Playing Politics with Our Health counters the misinformation that is being spread by opponents of reform, particularly regarding the individual responsibility requirement, and presents the facts about their efforts to block reform. (April 2010)
A Summary of the New Health Reform Law describes the major changes in health coverage that health reform will bring, including Medicaid and CHIP coverage, the affordability provisions, the exchanges, individual and employer responsibility requirements, improvements in private market coverage, and changes to Medicare and long-term services. (April 2010)
What Will the New Health Reform Law Do in the First Year? discusses how health reform will help people with pre-existing conditions, young adults, people on Medicare, small businesses, community health centers, and others in its first year. (April 2010)
Health Coverage in the States: How Will Health Reform Help? discusses the major gaps in each state's health coverage system and how health reform will address these gaps and help state residents, including the insured, the uninsured, people in Medicare, and small businesses. (March 2010)
Information on Specific Areas of the Law
Accountable Care Organizations (ACOs)
Making the Most of Accountable Care Organizations (ACOs): What Advocates Need to Know provides an overview of ACOs; the promise they hold; and how they could change Medicare, Medicaid, and the health care landscape. It also identifies key challenges in their development and suggests how advocates can get involved in ways that benefit patients. (Updated February 2012)
A Closer Look at ACOs is a compilation of Families USA briefs done on Accountable Care Organizations. Includes the basics, payment and quality measurements, determining shared savings and losses, and beneficiary assignment and notification processes. (February 2012)
Designing Consumer-Friendly Beneficiary Assignment and Notification Processes for Accountable Care Organizations discusses the challenges advocates will face when developing these processes, and it recommends certain notification requirements and beneficiary protections. (January 2012)
Putting the Accountability in Accountable Care Organizations: Payment and Quality Measurements examines some of the challenges that advocates will face when working with policy makers, insurers, and providers to develop mechanisms that ensure that beneficiaries receive high-quality care at a lower cost. | Determining Shared Savings or Losses (January 2012)
Enrollment
Simplifying Enrollment and Eligibility with Modified Adjusted Gross Income (MAGI) explains the benefits of aligning income calculation rules in Medicaid, CHIP, premium tax credits, and Basic Health programs (where applicable) through MAGI. (October 2011)
Presumptive Eligibility: A Step toward Streamlined Enrollment in Medicaid and CHIP explores how the Affordable Care Act expands presumptive eligibility to help states streamline enrollment and discusses the important role that presumptive eligibility can play in helping low-income people get access to care during and after the implementation of the new law. (September 2011)
The Basic Health Option: Will It Work for Low-Income Consumers? provides a framework for advocates to think about whether this option, created by the health care law, will work for their state. It covers program basics, discusses the problems it might address, and raises key issues that can affect the direction such a program might take. (July 2011)
Enrollment Policy Provisions in the Patient Protection and Affordable Care Act outlines the provisions that apply to Medicaid, CHIP, and the exchanges, and those that encourage coordination of enrollment procedures among the three programs. (Updated December 2010)
How States Are Making Sure Coverage Is Available to Children notes that, under health reform, insurers are required to accept children regardless of any pre-existing conditions in all group plans and in newly sold individual plans, and it examines what several states are doing to make sure that child-only policies are still available. (October 2010)
How Health Reform Helps Low-Income Children discusses how health reform sustains Medicaid and CHIP funding, enhances enrollment in the programs, further expands children's coverage, and increases their health care benefits. (July 2010)
Exchanges
Key Issues in the Final and Interim Final Rules on Establishing Exchanges and Expanding Medicaid under the Affordable Care Act (April 2012)
The Basic Health Option: Will It Work for Low-Income Consumers? provides a framework for advocates to think about whether this option, created by the health care law, will work for their state. It covers program basics, discusses the problems it might address, and raises key issues that can affect the direction such a program might take. (July 2011)
Why We Need a Health Insurance Exchange is a one-page handout that cites several reasons why consumers will benefit from the new exchanges, including competition, affordability, and quality. Advocates can modify this version to fit their needs. (June 2011)
Obtaining Exchange Funding and Achieving Consumer-Friendly Outcomes: A State "To Do" List outlines tasks states need to complete to obtain federal exchange grants and move ahead with implementation of an exchange. (May 2011)
Options for Governance and Oversight highlights key issues to consider in the creation of a successful, consumer-friendly governance structure, including where the exchange should be housed, good governance, and duties of a board. (April 2011)
Selecting Plans to Participate in an Exchange: A State Guide is designed to help stakeholders understand what's involved and how the process can be structured in the best interest of state residents. It reviews the federal minimum standards, discusses additional elements to consider, and offers specific state examples. (February 2011)
Implementing Health Insurance Exchanges: A Guide to State Activities and Choices describes the requirements in the Affordable Care Act that exchanges must meet and outlines key questions that states and consumer advocates will need to consider as the exchanges are designed. (October 2010)
Health Equity
At Risk in the Budget Battle: Health Care for Communities of Color illustrates the disproportionate impact deficit reduction could have on communities of color. This fact sheet demonstrates how protecting Medicare, Medicaid, and the Affordable Care Act are important for advancing health equity. (December 2012)
How Health Reform Helps Communities of Color is a series of state-based fact sheets that discuss how provisions in the Affordable Care Act--both those for the general public and those specifically designed to eliminate health disparities--help communities of color in each state. (September-October 2010)
How Health Reform Helps . . . is a series of fact sheets that highlight how the new health reform law will help America's communities of color by expanding coverage, increasing funding for community health centers, and providing grants for workforce diversity. (September 2010) African Americans l American Indians and Native Alaskans l Asian Americans l Latinos l Native Hawaiians and Other Pacific Islanders
Moving toward Health Equity: Health Reform Creates a Foundation for Eliminating Disparities summarizes provisions that will expand access to care through Medicaid and community health centers, and that address health disparities by promoting language access, increasing workforce diversity, and reauthorizing the Indian Health Care Improvement Act. (May 2010)
Health Reform: Help for American Indians and Alaska Natives discusses changes made by the new health reform law, including the overdue reauthorization of the Indian Health Care Improvement Act, and explains how these changes will benefit these two groups. (May 2010)
Reducing Racial and Ethnic Health Disparities: Key Health Equity Provisions (March 2010)
Long-Term Services and Supports
The Health Care Law: Good News for Caregivers discusses how the health care law will help build the long-term care workforce, encourage states to expand home- and community-based services in Medicaid, improve resources for caregivers, and expand protections for people in long-term care facilities. | The Affordable Care Act: Provisions that Will Help Caregivers (March 2011)
States Are Benefitting from Provisions of the Affordable Care Act lists the number of people in each state who are already benefiting from each of five provisions. The provisions include measures that are helping small businesses provide coverage to their workers, helping seniors get free preventive care, and protecting children with pre-existing conditions. | Table (March 2011)
Better Safety and Quality for Seniors and People with Disabilities discusses the Elder Justice Act, the Patient Safety and Abuse Prevention Act, and the Nursing Home Transparency and Improvement Act, three sections in the Affordable Care Act that will bring historic improvements to the quality and safety of long-term care and result in the most comprehensive federal effort ever to fight elder abuse. (October 2010)
Help for Those Who Need Long-Term Care describes how the Affordable Care Act will help more people stay in their homes or the community (rather than an institution) and why this help is needed. (September 2010)
Health Reform Provisions that Expand Access to Home- and Community-Based Services (HCBS) briefly outlines key provisions, including the State Balancing Incentive Payments Program, the Community First Choice Option, and Changes to the Medicaid 1915(i) option. (September 2010)
Health Reform: New Opportunities for States to Invest in Home- and Community-Based Services is a series of state-specific fact sheets that explore the new options for states to expand home- and community-based services through the health reform law and the reasons why expanding this type of services is a good idea. (Summer 2010)
Helping People with Long-Term Health Care Needs: Improving Access to Home- and Community-Based Services in Medicaid discusses how health reform gives states incentives to strengthen home- and community-based services in Medicaid. (Updated April 2010)
Helping People with Long-Term Health Care Needs: An Insurance Program to Help People Afford Long-Term Services and Supports discusses the Community Living Assistance for Services and Supports (CLASS) program, a new, voluntary, public long-term services insurance program that is part of health reform. (Updated April 2010)
Medicaid
The Supreme Court Decision: What It Means for Medicaid gives an in-depth look at the Court's ruling on Medicaid and what advocates can do to make sure their state expands coverage. (August 2012)
Investing in Medicaid Contributes to Better Education explains how Medicaid coverage can actually help children in ways that help them perform better at school. (August 2012)
Key Issues in the Final and Interim Final Rules on Establishing Exchanges and Expanding Medicaid under the Affordable Care Act (April 2012)
The Basic Health Option: Will It Work for Low-Income Consumers? provides a framework for advocates to think about whether this option, created by the health care law, will work for their state. It covers program basics, discusses the problems it might address, and raises key issues that can affect the direction such a program might take. (July 2011)
Medicaid and the Affordable Care Act: Reframing the Debate addresses concerns about the effect of the Medicaid expansion on state budgets and outlines the many benefits that the Medicaid expansion will bring to states and the uninsured. (October 2010)
Early Medicaid Expansions under Health Reform discusses how states can expand their Medicaid programs under a state plan amendment prior to 2014-and why they should. (April 2010)
Maintenance of Effort Requirements under Health Reform discusses how health reform changes the maintenance of effort requirements that are already in place for state Medicaid and CHIP programs. (March 2010)
Medicare
Emphasizing Preventive Care and Wellness in Medicare: This series of fact sheets discusses how Medicare is taking an important step forward, thanks to the Affordable Care Act, to provide more preventive and wellness care to beneficiaries. These fact sheets highlight how beneficiaries can take advantage of these benefits and how advocates can answer questions and resolve problems. (Updated February 2012)
For consumers: Medicare's Preventive Care Benefit: What It Means for You l Medicare's Annual Wellness Visit: What It Means for You
For advocates: An Advocate's Guide to the Preventive Services Benefit in Medicare l An Advocate's Guide to the Annual Wellness Visit Benefit in Medicare
Helping People with Medicare discusses how health reform will help make Medicare more affordable for seniors and people with disabilities, improve health care quality for enrollees, and make the program more financially secure. (Updated September 2011)
An Advocate's Guide to the Medicare Coverage Gap Discount Program is a troubleshooting guide for advocates who assist beneficiaries with navigating the new program, including answers to frequently asked questions. (December 2010)
Help in the Doughnut Hole: the Medicare Coverage Gap Discount Program discusses the basics of this program, including the 2010 rebate checks, the 2011 discounts, changes in drug availability, and dispute resolution. (December 2010)
Welcome to the Medicare Prescription Drug Benefit for 2011 is an updated illustration that reflects improvements made by the Affordable Care Act that will lessen the amount enrollees will pay when they fall into the "doughnut hole." (November 2010)
Lower Costs, Better Care: Medicare Cost Savings in the Affordable Care Act discusses how the Affordable Care Act will make Medicare work more efficiently by improving the way providers deliver care, modernizing how Medicare pays for services, and eliminating waste, fraud, and abuse in the system. | Talking Points (September 2010)
Rights and Protections under the Law
The Affordable Care Act: Patients' Bill of Rights and Other Protections is a compilation of all of our fact sheets to date on consumer rights and protections. (April 2011)
Individual fact sheets on the Patients' Bill of Rights and other consumer protections in the Affordable Care Act that took effect on September 23. (September 2010)
Grandfathered Plans under the Patient Protection and Affordable Care Act discusses health plans that existed on the date that health reform was enacted and are therefore exempt from some provisions of the law. It explains the requirements health plans must meet to maintain grandfathered status and outlines which protections in the health reform law apply to such plans and which do not. 6 pp. (Updated December 2010)
Health Coverage for Young Adults: Health Reform Will Soon Allow You to Stay on Your Parent's Health Plan is a fact sheet aimed at young adults (and their parents) that is designed to answer important questions about this new opportunity to keep or obtain health coverage for young adults up to age 26. (May 2010)
Health Reform: Help for Americans with Pre-Existing Conditions discusses how, under health reform, no one will be denied coverage, charged a higher premium, or sold a policy that excludes coverage of essential benefits because of pre-existing conditions. The report presents the number of Americans with diagnosed pre-existing conditions who, absent reform, would be at risk of being denied coverage in the individual insurance market. It breaks down this number by age, income, and race. | State Reports (May 2010)
Tax Credits
Lower Taxes, Lower Premiums: The New Health Insurance Tax Credit examines how this tax credit will help both insured and uninsured Americans. It provides data on the number of people eligible, the total dollars available, and on how it will help working families in particular. | State Reports (September 2010)
A Helping Hand for Small Businesses: Health Insurance Tax Credits analyzes the health reform provision that provides tax credits to small employers to help them buy health coverage for their workers. This report, which was commissioned along with Small Business Majority, provides national and state-level data on the number of small businesses eligible for the credit in 2010, as well as the number eligible for the maximum tax credit. (July 2010)
Other Topics
Being a Woman Just Got a Little Easier: How the Affordable Care Act Benefits Women outlines what women stand to gain under the Affordable Care Act. (July 2012)
Working toward Wellness: A Checklist for Creating Consumer-Friendly Workplace Wellness Programs lays out the components for building a workplace wellness program that promotes health and well-being while protecting participants' health coverage and privacy. Our companion piece includes profiles of five wellness programs from across the country. (July 2012)
Wellness Programs: Evaluating the Promises and Pitfalls presents an overview of current programs, identifies how their role could soon change, explains how certain programs can limit access to coverage and care, and provides recommendations for policies that will help prevent these programs from limiting access. (June 2012)
When a Health Insurer Leaves the Individual Market: What States Can Do before Certain Affordable Care Act Changes Take Effect in 2014 discusses specific actions states can take to protect consumers who need to buy coverage in the individual market. It examines existing protections and explains how states can supplement them. (May 2012)
Decoding Your Health Insurance: The New Summary of Benefits and Coverage provides national and state-level data on the nearly 173.5 million people with private insurance who will be helped by these plain-language summaries that are required by the health care law. (May 2012)
Designing Consumer-Friendly Beneficiary Assignment and Notification Processes for Accountable Care Organizations discusses the challenges advocates will face when developing these processes, and it recommends certain notification requirements and beneficiary protections. (January 2012)
Putting the Accountability in Accountable Care Organizations: Payment and Quality Measurements examines some of the challenges that advocates will face when working with policy makers, insurers, and providers to develop mechanisms that ensure that beneficiaries receive high-quality care at a lower cost. | Determining Shared Savings or Losses (January 2012)
Buyer Beware: Unlicensed Insurance Plans Prey on Health Care Consumers reports on actions that states have taken against American Trade Association, Serve America Assurance, and Smart Data Solutions. It also discusses the sale of phony insurance more generally, weaknesses in oversight of association health plans, and new protections under the Affordable Care Act. (October 2010)
Rate Review: Holding Health Plans Accountable for Your Premium Dollars discusses common problems with the process of reviewing health insurance premium rates, the lessons learned from state rate review procedures, and how health reform will address these problems. (Updated April 2010)
Medical Loss Ratios: Making Sure Premium Dollars Go to Health Care—Not Profits discusses medical loss ratios, state requirements regarding medical loss ratios, and why medical loss ratio requirements are so important for protecting consumers. (February 2010)
Talking about Reform
How Health Reform Helps the States is a series of short fact sheets with state-specific data showing how residents have benefitted from the Affordable Care Act so far and how they'll continue to benefit as the law is implemented. (February 2012)
Talking Turkey is a short piece that is designed to help people talk about the benefits of the Affordable Care Act in an informal way, even at the Thanksgiving table. (November 2011)
Messaging Cheat Sheet: Mastering the 30-Second Sound Byte is a compilation of tips from messaging experts about how to talk about the Affordable Care Act and how to respond effectively to opponents of the law. (July 2011)
Why We Need a Health Insurance Exchange is a one-page handout that cites several reasons why consumers will benefit from the new exchanges, including competition, affordability, and quality. Advocates can modify this version to fit their needs. (June 2011)
"Defunding" the Affordable Care Act: Guilty of a Double Standard discusses the important new rights and benefits that many in the House of Representatives are planning to take away from millions of Americans but intend to keep for themselves (at taxpayer expense) when they vote to defund or repeal the Affordable Care Act. The piece lists 14 rights and benefits. (February 2011)
In this video, "Modern Healthcare" Managing Editor Neil McLaughlin discusses the impact of the Patient Protection and Affordable Care Act with Ron Pollack, who argues that the more patients and providers know about specific aspects of the law, the more favorably they view it. (July 26, 2010)
Health Reform: Laying the Foundation for Equity is a PowerPoint presentation that provides an overview of some the provisions in the new law that will help close the gap, including prevention and public health, coverage expansions, and initiatives that specifically address health care disparities. The notes section includes a script that has a more in-depth discussion of each topic.
Health Reform: Why We Should Celebrate is a PowerPoint presentation that outlines the benefits of health reform for different groups. There is a script in the notes section of each slide that provides more in-depth discussion of each topic.
Medicare, Health Reform, and You is a PowerPoint presentation that dispels rumors about how health reform will affect Medicare and lays out how Medicare will actually be improved. The notes section includes a script that has a more in-depth discussion of each topic.
Responding to Attacks on Health Reform
Got Health Insurance? Think you don't need reform? Think again!
Making the Case for Progressives: The Social Security and Medicare Examples
Health Reform Talking Points for Moderates
Other Resources
From the Herndon Alliance:
Health Insurance Reform: Security for America's Middle Class
Winning the Debate on Health Care Reform
From the Center on Budget and Policy Priorities:
Health Reform Will Reduce the Deficit: Charges of Budgetary Gimmickry Are Unfounded debunks several claims that challenge the health reform provisions that would lower costs and reduce the deficit. For example, opponents claim that the law cannot “bend the cost curve” while expanding coverage to 32 million people. However, the law contains a wide variety of cost-cutting provisions that are projected to reduce the growth in health care spending over the long term. (March 2010)
[Return to top]
