National Health Care Reform: Issues and Outlook. Worldwide Employee Benefits Network Cleveland, OH. April 16, 2009. James C. Capretta Fellow, Ethics and Public Policy Center email: [email protected] Content. Issues driving reform agenda Outline of the emerging Congressional plan
Source: Income, Poverty, and Health Insurance Coverage in the United States: 2007, Census Bureau, Table C-1.
Source: “A Primer on the CPS Estimate of America’s Uninsured,” National Institute for Health Care Management, August 2006.
Sources: Income, Poverty, and Health Insurance Coverage in the United States: 2006, Census Bureau, Table A-1, and CMS National Health Expenditure Data (www.cms.gov).
Source: Notes, Employee Benefit Research Institute, Vol. 26, No. 10, October 2005, Figure 3.
Some Key Features
Small Business Employees (under 50)
New Entrants, Others
2007 Total = $246.1 (billions)
Federal Payroll Taxes
Federal Income Taxes
Source: “Tax Expenditures for Health Care,” Joint Committee on Taxation, JCX-66-08, July 30, 2008.
Source: Tax Expenditures for Health Care, Joint Committee on Taxation, JCX-66-08, July 30 2008, p. 5.
“Pay or Play” Employer Tax
$ Spent on Health Coverage
Employer-Sponsored Insurance (ESI) Premium Per Worker
Pay or Play Tax >
Pay or Play Tax <
Average Wage Per Employee
Laws Enacted Via Reconciliation
The bottom line: budget reconciliation process allows bills to pass in the U.S. Senate with 51, instead of 60, votes.
Entitlement Cuts + Tax Increases = >
Entitlement Increases + Tax Cuts
Source: The Long-Term Budget Outlook, CBO, December 2007 (extended baseline scenario).
“Engineering” a More Cost-Effective Delivery System:
*Excess Cost Growth is per capita spending growth rate in excess of per capita GDP growth.
*Source: The Long-Term Outlook for Health Spending, CBO, November 2007.