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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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Presentation Transcript
slide1

Healthcare Reform

Bryan Lagg

Blue Cross Blue Shield of Mississippi

slide2

Major Timelines Related to Healthcare Reform

2010 - 2011: Market Reform

2012 - 2013: Financing Alignment

2014 - Ongoing: The Exchange / Individual Mandates

slide3

2010 Provisions

March 23, 2010

January 1, 2010

Rate Review

Small Business

Tax Credits

Consumer

Information

Grants to States

Grandfathered

Plan Status

in Effect

slide4

Key Provisions:

Employer Responsibility (Tax)

slide5

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%

slide6

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%

slide7

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%

slide8

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%

slide9

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

slide10

Preventive Measures

Healthy You! Compared to USPSTF

slide11

Preventive Measures

Healthy You! Compared to USPSTF

slide12

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

slide13

Long-Term Provisions

2013

2014

Contribution limits

on HSAs

$8B insurer fee

Itemized deductions for

unreimbursed medical

expenses

Medicare taxes

slide15

Long-Term Provisions

2013

2014

Contribution limits

on HSAs

$8B insurer fee

Itemized deductions for

unreimbursed medical

expenses

Health insurance

Exchanges

Medicare taxes

slide19

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%

slide20

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

slide21

Key Provisions:

Individual Mandate and Subsidies

slide22

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

slide23

Key Provisions:

Employer Requirements

slide24

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

slide25

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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