THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA) FROM A

SOCIAL JUSTICE PERSPECTIVEPub. L. No. 111-148, 124 Stat. 119 (2010)Pub. L. No. 111-152, 124 Stat. 1029(2010)

Students:

Eric DanielsonDawn FrostCheryl GimmesonTom Kurdy

Lewis-Clark State CollegeSocial Work Program

NATIONAL ASSOCIATION OF SOCIAL WORKERS PERSPECTIVE ON SOCIAL JUSTICE AND NATIONAL

HEALTH CARE

Social Justice: everyone deserves equal economic, political and social rights

and opportunities* access and opportunity for everyone, particularly those in

greatest need*

Health Care Perspective: health care policy that ensures the right to universal access

to a continuum of health and mental health care throughout all stages of the life cycle**

participation of social workers on public and private health care policy**

promote and facilitate evaluation and research to contribute to the development of knowledge**

*(Code of Ethics of the National Association of Social Workers, 1996, rev. 2008).**(National Association of Social Workers, Social Work Speaks, Health Care Policy Statement, 2008).

U.S. DEPT. OF HEALTH AND HUMAN SERVICES

PERSPECTIVE ON HEALTH CARE

Vision: A society in which all people live long, healthy livesMission: Identify nationwide health improvement priorities Increase public awareness and understanding Engage sectors to take actions driven by best evidence and

knowledge Identify critical research, evaluation, and data collection

needs Provide measurable objectives and goals

HEALTHY PEOPLE 2020 The nation’s 10 year goals for health promotion and disease prevention.

(U.S. Department of Health and Human Services, Healthy People 2020, News Release and Website Launch, 2010).

Goals: Attain High Quality, longer lives Achieve equity, eliminate disparities, improve health for all groups Create social and physical environments that promote good health Promote healthy development throughout all stages of life

PPACA, A PERSPECTIVE OF IDAHO INDIGENT CARE

PPACA will shift burden from state CAT/Indigent care to Medicaid* Income eligibility increases to 133% of fed

poverty level No requirement of children in home Increased number of adult ,non-disabled Requires individuals to be insured Pre-existing Condition Insurance Program (PCIP

Federal in Idaho) Idaho premium purchase

*Healthcare.gov/law/features, (2012) **Office of the Idaho Department of Health and Welfare, (2012).

Estimated Fed/State Medicaid Share**Federal Medicaid share 75%State Medicaid share 25%

EXAMPLE OF ESTIMATED IDAHO COST SAVINGS

Rusche, (2012). & Id. DHW, (2012)

2011 Idaho Catastrophic Care Funding$78MID DHW Estimates 90% will shift to Medicaid

Under PPACA Full Implementation:ID burden would be (10% x $78M) + (25%(90% x $78M)) = $25.35M

a 67.5% decrease in ID General Fund funding

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0

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1000

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2500

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CAT

Indigent

CATIndigent

2007 2008 2009 2010

Idaho residents eligible forIndigent and CAT services

Federal burden from ID 75%(90% x $78M) = $52.65MFed burden all 50 states 50 X 75%(90% x $78M) = $2.6B