1. Prospects for Federal Health Legislation 2008 Health Care Forecast Conference February 21, 2008 Terri Shaw The Children’s Partnership

2. Overview • Context for (in)action this year • Prospects for Congressional action • Prospects for Executive action

3. Context for (In)Action On the one hand… • Election year • Veto threats • Pay-go

4. Context for (In)Action On the other hand… • “Must-do” items • Executive activism • Health care continues to be a high-priority item for voters

5. Prospects for Congressional Action • “Must-do” items • Health • Medicare • Medicaid/SCHIP • Not directly/exclusively health-related • Economic stimulus • AMT and tax extenders • Appropriations • No Child Left Behind?

6. Prospects for Congressional Action • Pending/unfinished items: • CHAMP Act • SCHIP reauthorization • Physician and other provider reimbursement changes • Reduce Medicare Advantage overpayments • Beneficiary improvements • Eliminate self-referral to physician-owned hospitals • Repeal trigger • Mental health parity • Genetic non-discrimination • Health IT • Comparative effectiveness

7. Cumulative savings: $15B over 5 years Prospects for Executive Action:Seven Medicaid Proposals Last Year Source: Center on Budget and Policy Priorities, February 13, 2008

8. Prospects for Executive Action • Regulatory proposals in the President’s budget include: • Medicaid/SCHIP: • Specify allowable Medicaid managed care savings • Additional SCHIP/Medicaid restrictions? • Medicare: • Reimbursement for hospitals, SNFs, hospice • Program integrity • Others?