may 8, 2013 pnc healthcare
DESCRIPTION
Grace-Marie Turner's May 8, 2013 presentation to the PNC HealthCare 2013 Spring Healthcare Advisory Panel.TRANSCRIPT
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Update on Health Reform
Grace-Marie TurnerMay 8, 2013PNC HealthCare 2013 Spring Healthcare Advisory BoardPhiladelphia
Americans agreed on goals for health reform…
• The U.S. needs health reform to:– make coverage more affordable– assure quality, and– expand access to insurance
• Most people rate their own coverage as good or excellent
• They want stability. Change was for others.
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but many say the ACA changes too much
• 36% of Americans now view the Affordable Care Act favorably
• 42% view the law unfavorably
• Cost continues to be the biggest concern
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Kaiser Health Tracking Poll, February 2013. http://www.kff.org/kaiserpolls/upload/8251-F.pdf
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Americans’ views of health law after Supreme Court decision
• Americans say it will make things worse rather than better for – taxpayers
– businesses
– doctors
– and those who currently have health insurance.
Sources: “Americans: Healthcare Law Helps Some, Hurts Others ,” Gallup, July 16, 2012, http://www.gallup.com/poll/155726/Americans-Healthcare-Law-Helps-Hurts-Others.aspx?utm_source=add%2Bthis&utm_medium=addthis.com&utm_campaign=sharing#.UARkmBS6osE.twitter. The New York Times/CBS News Poll, July 11-16, 2012, http://s3.documentcloud.org/documents/402362/jul12a-ocr.pdf. “Kaiser Health Tracking Poll,” The Kaiser Family Foundation, July 2012, http://www.kff.org/kaiserpolls/upload/8339-C.pdf
Why the ACA isn’t settled
38% of Americans supported the law in the last major poll before the November elections
Of the 50.6% who voted for President Obama…
12% said they wanted the law repealed
The election was not about health reform
Source: “Kaiser Health Tracking Poll: October 2012,” The Henry J. Kaiser Family Foundation, October 31, 2012, http://www.kff.org/kaiserpolls/8381.cfm.
NOTE: Don’t know/Refused answers not shown.SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)
Majority Say They Don’t Understand How ACA Will Impact Them, Including
Two-Thirds of Uninsured and Low-Income
Do you feel you have enough information about the health reform law to understand how it will impact you personally, or not?
30%
33%
41%
68%
67%
57%
Household income lessthan $40,000
Uninsured (under age 65)
Total
Yes, have enough information No, do not have enough information
Source: Avik Roy, “Fact-Checking the Obama Campaign's Defense of its $716 Billion Cut to Medicare,” Forbes: The Apothecary, August 16, 2012, http://www.forbes.com/sites/aroy/2012/08/16/fact-checking-the-obama-campaigns-defense-of-its-716-billion-cut-to-medicare/.
The health law in one graph
The paperwork maze
Courtesy of The Wall Street Journal at www.opinionjournal.com
Source: Sarah Kliff, “Is ObamaCare too much work for the Obama administration?” The Washington Post, November 12, 2012, http://www.washingtonpost.com/blogs/wonkblog/wp/2012/11/12/is-obamacare-too-much-work-for-the-obama-administration/.
An ACA State Exchange
Do you qualify for subsidies?
Source: Sen. John Cornyn, Facebook, March 22, 2013, http://www.facebook.com/photo.php?fbid=10151499130834424&set=a.112318184423.92543.75755694423&type=3&l=83fcd3ca01&permPage=1
The Red Tape Tower
Source: “Health Reform Poses Biggest Challenges to Companies with the Most Part-Time and Low-Paid Employees,” Mercer LLC, August 8, 2012, http://www.mercer.com/press-releases/1472805.
Mercer: Employers planning workforce changesw Mercer study on what employers expect
SCOTUS Success Boot Camp
Employers and health coverage
1. Employers with <50 FTE EE’s have no 3k/2k penalty
2. But employers offering qualified and affordable coverage may actually be hurting their employees
Example
Generous Subsidies in ExchangesExamples:
• A person earning $42,000 a year with a family of 4 qualifies for $14,759 in new health insurance subsidies
• A single person earning $20,600 qualifies for $5,156 in new health insurance subsidies
But only if employer doesn’t offer coverage or if it’s not “affordable” (ie costs >9.5% of income)
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Cost of Insurance, Family of 4
Impact of new rating rules
James T. O’Connor, Milliman, for America’s Health Insurance Plans. Comprehensive Assessment of ACA Factors That Will Affect Individual Market Premiums in 2014. http://www.ahip.org/MillimanReportACA2013/ Accessed 4-26-13
New and higher Taxes
Source: Philip Dittmer and William McBride, “Obamacare's New Taxes, And How You May Be Affected,” Tax Foundation, July 5, 2012, http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
More new and higher Taxes
Source: Philip Dittmer and William McBride, “Obamacare's New Taxes, And How You May Be Affected,” Tax Foundation, July 5, 2012, http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
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Some realities:
What we know for sure
• CHOICE: Americans value innovation, diversity and choice to accommodate 300 million people
• VALUE IN HEALTH SPENDING: To realize the promise of personalized medicine and achieve overall cost saving, break down payment silos
• FOCUS ON THE PATIENT: They want doctors and patients, not government, to make health care decisions
A market-based solution“Defined contributions” for health coverage
A system that puts doctors and patients in charge of medical decisions
Restructuring financing for a 21st century health sector
• Medicare
• Medicaid
• Private Insurance
States have a big role
Seek ways improve their markets
• Enhance competition for more choices of affordable coverage
• Better safety net with functional high-risk pools
• Private exchanges?
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Health insurance market
2013 questions
• Will Exchanges be ready by Oct 1?
• Will there be bi-partisan support for delay?
• Will people enroll after they see cost?
• Will the number of uninsured be higher as people understand guaranteed issue?
• Will private exchanges fill a market need?
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Europeans moving toward patient-centered care/decentralization
• Consumerism
• Value of private enterprise and competition
• Doctor-patient relationship
• Decentralized decision-making
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The future?• The global move toward
consumerism is real, driven by greater patient demand for more control over decisions.
• People will seek more affordable options outside the ACA’s centralized control.
A not-for-profit health and tax policy research organization
/GalenInstitutewww.galen.org
Grace-Marie Turner
Galen Institute
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