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Healthcare Reform

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

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  1. Healthcare Reform Bryan Lagg Blue Cross Blue Shield of Mississippi

  2. Major Timelines Related to Healthcare Reform 2010 - 2011: Market Reform 2012 - 2013: Financing Alignment 2014 - Ongoing: The Exchange / Individual Mandates

  3. 2010 Provisions March 23, 2010 January 1, 2010 Rate Review Small Business Tax Credits Consumer Information Grants to States Grandfathered Plan Status in Effect

  4. Key Provisions: Employer Responsibility (Tax)

  5. 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%

  6. 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%

  7. 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%

  8. 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%

  9. 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

  10. Preventive Measures Healthy You! Compared to USPSTF

  11. Preventive Measures Healthy You! Compared to USPSTF

  12. 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

  13. Long-Term Provisions 2013 2014 Contribution limits on HSAs $8B insurer fee Itemized deductions for unreimbursed medical expenses Medicare taxes

  14. Key Provisions: Financing

  15. Long-Term Provisions 2013 2014 Contribution limits on HSAs $8B insurer fee Itemized deductions for unreimbursed medical expenses Health insurance Exchanges Medicare taxes

  16. Key Provisions: Exchanges

  17. Key Provisions: Exchanges

  18. Small Business Tax Credits

  19. 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%

  20. 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

  21. Key Provisions: Individual Mandate and Subsidies

  22. 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

  23. Key Provisions: Employer Requirements

  24. 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

  25. 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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