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A Quick Look at Presidential Candidate Health Reform Plans and What’s Cooking in Harrisburg

A Quick Look at Presidential Candidate Health Reform Plans and What’s Cooking in Harrisburg. Adam Brackemyre National Association of Health Underwriters April 18 th , 2008. Overview. Sen. Obama health plan Sen. Clinton health plan Sen. McCain health plan What’s happening here in Pennsylvania.

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A Quick Look at Presidential Candidate Health Reform Plans and What’s Cooking in Harrisburg

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  1. A Quick Look at Presidential Candidate Health Reform PlansandWhat’s Cooking in Harrisburg Adam BrackemyreNational Association of Health UnderwritersApril 18th, 2008

  2. Overview • Sen. Obama health plan • Sen. Clinton health plan • Sen. McCain health plan • What’s happening here in Pennsylvania

  3. Before we begin… • As you know, Congress must pass and the President sign legislation for anything to become law. • The Senator’s proposal will be altered. • In some cases, nothing happens (Pres. Clinton health plan, Pres. Bush Social Security reform) • Congressional balance will matter. • Economic conditions will matter.

  4. Presidential Candidates • Health care will be a top domestic policy issue during this extended campaign cycle. • Some candidates favor comprehensive reform that could dismantle the private market • All candidates favor Rx reimportation • Single payer, national exchanges, shift away from the employer-based system all under serious debate. • NAHU’s analysis of presidential health care reform proposals is updated regularly and available online.

  5. Presidential PlatformsSenator Barack Obama (D-IL) • Wants universal coverage by 2012 • States, employers, and private plans to GI, no pre-ex • Lower costs and improve quality • Focus on preventive care, wellness, and public health • Create national “exchange” with federal coverage standards • Mandate children covered up to age 25 • Cost estimate is $50-$60 Billion a year • Strengthen anti-trust laws to provide cheaper med-mal insurance • Private insurers must invest a percentage of premiums to patient care in non-competitive areas

  6. Presidential PlatformsSenator Barack Obama (D-IL) • “Guaranteed coverage through employers, private health plans, the federal government and the states.” • Expand Medicaid and SCHIP. • All children required to have health coverage. • Employers will have to offer “meaningful” coverage, pay a percentage, or pay into a pool. (Requires an ERISA amendment)

  7. Presidential PlatformsSenator Hillary Clinton (D-NY) • Cost Containment – preventive/chronic disease management, paperless IT, reduce admin costs. • Private Insurance – insurers must cover preventive care and meet MLR • GI and modified community rating • “Choice” 1) Keep current private coverage 2) Buy into expanded FEHBP 3) Health Care Choices (public FEHBP)

  8. Presidential PlatformsSenator Hillary Clinton (D-NY) • Individual/Employer mandate • Details and penalties to be spelled out later. • Estimated cost is $110 Billion a year. • A time-limited reinsurance plan to help private retiree plans. • Some financing details: • Will limit the employer tax exclusion. • Will not renew the Bush tax cuts for those earning $250,000 and above.

  9. Presidential PlatformsSenator John McCain (R-AZ) • Eliminate fed income tax exclusion for employer-sponsored insurance • Replace the exclusion with a tax credits - $2500/$5000 • Portable health insurance plans/multi-year plans • Multi-year plans are common in Europe • Coverage across state lines • Purchase health insurance through any association or organization they choose • Associations meet “rigorous standards” to be certified • Transparency with medical outcomes/quality of care • Expand the VA program to use benefits for timely high-quality care

  10. Presidential Race • The easy part: Sen. McCain for the GOP • Sen. Obama leads in total and pledged delegates • Superdelegates will play a role • What to do with the Michigan and Florida Dem delegations? (GOP cut them by half) • Will the Dem race be settled at national convention?

  11. Pennsylvania • Gov. Rendell’s Cover All Pennsylvanians proposal • Broken into a multitude of bills • One part is Access to Basic Care (ABC) • SB 1137 • State buy-in plan for low income residents • Finding money for the program has been difficult • This program has been tied to the MCARE reauthorization

  12. Pennsylvania • HB 2005 establishes a minimum loss ratio of 85% • This proposal has been introduced in other states. • What is an “administrative cost?” Taxes? Wellness programs? Disease management? Producer commissions? • How will this affect HSAs?

  13. Pennsylvania • HB 2005 also… • Implements community rating. • This has always been a contentious issue in Pennsylvania. • Permits the PA Department of Insurance to establish minimal coverage standards.

  14. Pennsylvania • You may have heard about the Independence and Highmark merger/consolidation. • The PA Department of Insurance has extended the public comment period. • This issue will consume an unknown amount of the legislature’s time and may or may not prevent legislators from focusing on other insurance reform.

  15. Don’t Forget to Vote (for Me) on Tuesday!

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