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Healthcare Reform. Bryan Lagg Blue Cross Blue Shield of Mississippi. Major Timelines Related to Healthcare Reform. 2010 - 2011: Market Reform 2012 - 2013: Financing Alignment 2014 - Ongoing: The Exchange / Individual Mandates. 2010 Provisions. March 23, 2010. January 1, 2010.

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Healthcare Reform

Bryan Lagg

Blue Cross Blue Shield of Mississippi


Major Timelines Related to Healthcare Reform

2010 - 2011: Market Reform

2012 - 2013: Financing Alignment

2014 - Ongoing: The Exchange / Individual Mandates


2010 Provisions

March 23, 2010

January 1, 2010

Rate Review

Small Business

Tax Credits

Consumer

Information

Grants to States

Grandfathered

Plan Status

in Effect


Key Provisions:

Employer Responsibility (Tax)


Main Street Mechanic Auto Repair Shop

Number of Employees: 10

Assumed Premiums: $70,000/year

Funding Percentage: 50%

Average Annual Wages: $25,000

Potential Tax Credit: 35%


Downtown Diner

Number of Employees: 40 Part-Time Employees (equivalent of 20 FTEs)

Assumed Premiums: $240,000/year

Funding Percentage: 50%

Average Annual Wages: $25,000

Potential Tax Credit: 35%


1st Street Family Services

(Non-profit Foster Care)

Number of Employees: 9

Assumed Premiums: $72,000/year

Funding Percentage: 50%

Average Annual Wages: $22,000

Potential Tax Credit: 25%


Acme Air Conditioning, LLC

(Manufacturer)

Number of Employees: 12

Assumed Premiums: $90,000/year

Funding Percentage: 50%

Average Annual Wages: $35,000

Potential Tax Credit: 35%


2010 Provisions

March 23, 2010

January 1, 2010

June/July, 2010

September 2010

Rate Review

Small Business

Tax Credits

(180 days out)

(90 days out)

HHS regulations

on state

Exchange waivers

National high

risk pool

Consumer Information

Grants to States

Part D

“Donut

Hole”

Decreased

Early retiree

reinsurance

grants

Grandfathered Plan

Status in Effect

HIT standards

Plan Years 6 Months Out

Sec. 833

Changes

Dependent Coverage to Age 26

July 1

Limits deductibility

of insurer

executive compensation

HHS Internet portal

No pre-ex exclusion

period < age 19

Part D

discounts in

“donut hole”

Preventive services

with no cost-sharing


Preventive Measures

Healthy You! Compared to USPSTF


Preventive Measures

Healthy You! Compared to USPSTF


2010 Provisions

March 23, 2010

January 1, 2010

June/July, 2010

September 2010

January 1, 2011

Rate Review

Small Business

Tax Credits

(180 days out)

MLR

rebates

(90 days out)

HHS regulations

on state

Exchange waivers

National high

risk pool

Consumer Information

Grants to States

Part D

“Donut

Hole”

Decreased

HSA/FSA

changes

Early retiree

reinsurance

grants

Grandfathered Plan

Status in Effect

HIT standards

Plan Years 6 Months Out

Sec. 833

Changes

Dependent Coverage to Age 26

July 1

Limits deductibility

of insurer

executive compensation

HHS Internet portal

No pre-ex exclusion

period < age 19

Part D

discounts in

“donut hole”

Preventive services

with no cost-sharing

No lifetime limits; restricted annual limits

Restrictions on Rescissions

MLR reporting


Long-Term Provisions

2013

2014

Contribution limits

on HSAs

$8B insurer fee

Itemized deductions for

unreimbursed medical

expenses

Medicare taxes


Key Provisions:

Financing


Long-Term Provisions

2013

2014

Contribution limits

on HSAs

$8B insurer fee

Itemized deductions for

unreimbursed medical

expenses

Health insurance

Exchanges

Medicare taxes


Key Provisions:

Exchanges


Key Provisions:

Exchanges



Acme Air Conditioning, LLC

(Manufacturer)

Number of Employees: 12

Assumed Premiums: $90,000/year

Funding Percentage: 50%

Average Annual Wages: $35,000

Potential Tax Credit: 35%


Long-Term Provisions

2013

2014

Contribution limits

on HSAs

$8B insurer fee

Itemized deductions for

unreimbursed medical

expenses

Health insurance

Exchanges

Individual

mandate and

subsidies

Medicare taxes


Key Provisions:

Individual Mandate and Subsidies


Long-Term Provisions

2013

2014

Contribution limits

on HSAs

$8B insurer fee

Itemized deductions for

unreimbursed medical

expenses

Health insurance

Exchanges

Individual

mandate and

subsidies

Medicare taxes

Employer

requirements


Key Provisions:

Employer Requirements


Long-Term Provisions

2013

2014

Contribution limits

on HSAs

$8B insurer fee

Itemized deductions for

unreimbursed medical

expenses

Health insurance

Exchanges

Individual

mandate and

subsidies

Medicare taxes

Employer

requirements

Medicaid

expansion

Risk Pool

eliminated


Final Summary:

State of the Union 2014

Coverage mandated/insufficient penalties

Government subsidies

Medicaid rolls increased

Exchange implemented/incentives to enroll

Rich benefit designs taxed

No real measures addressing cost,

only attempts to increase access;

rates will increase


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