national health care reform: what is it and what does it mean to you?

National HEALTH CARE REFORM

Robert R. Pohls Pohls & Associates 1550 Parkside Drive, Suite 260 Walnut Creek, California 94596 T: 925.973.0300 F: 925.973.0330 E-mail: [email protected]

2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010

What Is It and What Does It Mean To You?

HEALTH CARE REFORM


SPEAKERS FORMAT QUESTIONS REMARKS

March 23, 2010 Patient Protection and Affordable Care Act

March 30, 2010 Health Care and Education Reconciliation Act of 2010


HEALTH CARE REFORM



Karen Davenport, MPA Director of Health Policy Center for American Progress

Previously ♦ Washington Director, Medicare Rights Center ♦ Sr. Program Officer, Robert Wood Johnson Foundation ♦ Member, White House Health Care Reform Task Force

HEALTH CARE REFORM



Robert Moffit, Ph.D. Director, Center for Health Policy Studies The Heritage Foundation

Previously ♦ Senior Official, DHSS and OPM ♦ Framed The Heritage Foundation’s Response to Pres. Clinton’s Health Care Reform Plan ♦ Helped Develop the Massachusetts Health Insurance Reform Initiative

HEALTH CARE REFORM



Previously ♦ Chair, Department of Planning & Public Affairs ♦ Board of Trustees ♦ Executive Committee

Robert Smoldt, MBA Chief Administrative Officer, Emeritus Mayo Clinic Assoc. Director, Health Care Policy Program Arizona State University

HEALTH CARE REFORM



Series of Questions

♦ How did we get here? ♦ What do we have? ♦ When and how will we feel it? ♦ Will it work? ♦ What will it cost and who will pay?

Closing Remarks

Questions from the Audience

HEALTH CARE REFORM



“. . . the hazards of sickness, accident, invalidism, involuntary unemployment, and old age should be provided for through insurance. This should be a charge in whole or in part upon the industries, the employer, the employee, and perhaps the people at large. “ Teddy Roosevelt (August 1912)

HEALTH CARE REFORM



HEALTH CARE REFORM



QUESTION: How did President Obama succeed, where others before him failed?

HEALTH CARE REFORM



Bipartisan Health Care Summit Blair House -- February 25, 2010

♦ Preventing waste and fraud ♦ Medical malpractice reform ♦ Reforming the insurance market ♦ Giving individuals choices ♦ Small businesses insurance pools

HEALTH CARE REFORM



Bipartisan Health Care Summit Blair House -- February 25, 2010

♦ Preventing waste and fraud

♦ Medical malpractice reform ♦ Reforming the insurance market ♦ Giving individuals choices ♦ Small businesses insurance pools

Further Exploration:

♦ Undercover investigations of health care providers ♦ Grants for alternatives to medical malpractice lawsuits ♦ Increasing Medicaid payments to doctors ♦ Expanding Health Savings Accounts (HSA’s)

HEALTH CARE REFORM



Affordable Care Act -- Reforms

♦ Alters rules for private health insurers ♦ Creates health benefit exchanges ♦ Imposes new requirements on employers ♦ Mandates individual coverage ♦ Changes Medicare and Medicaid ♦ Commits $350 million to fighting waste, fraud and abuse ♦ Creates incentives for improving the quality of care ♦ Reforms the health care delivery system ♦ Modifies the tax code

HEALTH CARE REFORM



Affordable Care Act -- Reforms

♦ Alters rules for private health insurers ♦ Creates health benefit exchanges ♦ Imposes new requirements on employers ♦ Mandates individual coverage ♦ Changes Medicare and Medicaid ♦ Commits $350 million to fighting waste, fraud and abuse ♦ Creates incentives for improving the quality of care ♦ Reforms the health care delivery system ♦ Modifies the tax code

QUESTION: What will the Affordable Care Act really change?

HEALTH CARE REFORM



Affordable Care Act – Implementation Schedule

♦ Medicare Part D coverage gap (start in 2010; continue to 2020) ♦ Small employer tax credits (2010); Large employer tax penalties (2014) ♦ Reforms physician payment models (2012) ♦ Tax penalties for individuals without qualifying coverage (2014) ♦ Increases minimum income eligibility level for Medicaid (2014) ♦ Creates health benefit exchanges (2014)

HEALTH CARE REFORM



Affordable Care Act – Implementation Schedule

♦ Medicare Part D coverage gap (start in 2010; continue to 2020) ♦ Small employer tax credits (2010); Large employer tax penalties (2014) ♦ Reforms physician payment models (2012) ♦ Tax penalties for individuals without qualifying coverage (2014) ♦ Increases minimum income eligibility level for Medicaid (2014) ♦ Creates health benefit exchanges (2014)

QUESTION: When -- and how -- will we feel the effect of the Affordable Care Act?

HEALTH CARE REFORM



Affordable Care Act – Primary Objectives

♦ Containing soaring medical costs

♦ Covering more uninsured people

♦ Producing better results for patients

HEALTH CARE REFORM



Affordable Care Act – Primary Objectives

♦ Containing soaring medical costs

♦ Covering more uninsured people

♦ Producing better results for patients

QUESTION: Will the Affordable Care Act achieve those goals?

♦ If so, how?

♦ If not, what more must be done?

HEALTH CARE REFORM



Congressional Budget Office -- Estimates

♦ Number of uninsured will be reduced by 32 million (2019)

♦ 24 million people will obtain coverage through health insurance exchanges (2019)

♦ 16 million more people will enroll in Medicaid and Children’s Health Insurance Program (2019)

♦ Projected Costs:

CBO: $938 billion (over 10 years)

White House: $100 billion saved (over 10 years) $1 trillion saved (years 11-20)

HEALTH CARE REFORM



QUESTION: Will the Affordable Care Act cost America money or save America money?

QUESTION: How will the costs of insuring more Americans be paid?

QUESTION: Who will pay the costs?

HEALTH CARE REFORM



Judicial Challenges

♦ Thomas More Law ED Michigan ruled on 10/13/2010 that the Center v. Obama individual mandate and penalties are constitutional

♦ Commonwealth ED Virginia heard oral arguments v. Sebelius on 10/18/2010; set to rule by 12/31/2010

♦ Florida v. DHHS ND Florida scheduled hearing for 12/16/2010

Mid-Term Elections

HEALTH CARE REFORM



Judicial Challenges

♦ Thomas More Law ED Michigan ruled on 10/13/2010 that the Center v. Obama individual mandate and penalties are constitutional

♦ Commonwealth ED Virginia heard oral arguments v. Sebelius on 10/18/2010; set to rule by 12/31/2010

♦ Florida v. DHHS ND Florida scheduled hearing for 12/16/2010

Mid-Term Elections

QUESTION: What future challenges to health care reform do you see?

HEALTH CARE REFORM



Karen Davenport, MPA Director of Health Policy Center for American Progress

Previously ♦ Washington Director, Medicare Rights Center ♦ Sr. Program Officer, Robert Wood Johnson Foundation ♦ Member, White House Health Care Reform Task Force

HEALTH CARE REFORM



Robert Moffit, Ph.D. Director, Center for Health Policy Studies The Heritage Foundation

Previously ♦ Senior Official, DHSS and OPM ♦ Framed The Heritage Foundation’s Response to Pres. Clinton’s Health Care Reform Plan ♦ Helped Develop the Massachusetts Health Insurance Reform Initiative

HEALTH CARE REFORM



Previously ♦ Chair, Department of Planning & Public Affairs ♦ Board of Trustees ♦ Executive Committee

Robert Smoldt, MBA Chief Administrative Officer, Emeritus Mayo Clinic Assoc. Director, Health Care Policy Program Arizona State University

National HEALTH CARE REFORM

Robert R. Pohls Pohls & Associates 1550 Parkside Drive, Suite 260 Walnut Creek, California 94596 T: 925.973.0300 F: 925.973.0330 E-mail: [email protected]



national health care reform: what is it and what does it mean to you?

Documents

health care delivery

quality of care reforms

affordable care actmarch

health benefit exchanges

private health insurers

nationalhealth care

insurance market

tax codequestion