Hot Topics in Health Care

1
Hot Topics in Health Care

• Andrew Holtz
• andrew_at_holtzreport.com
• Atlanta, 27 April 2007

2
Three in the News

• Medicare Prescription Drug Coverage
• Part D What are A, B, C?
• Covering Children
• SCHIP Federal State joint programs
• State Health Care Reform Examples

3
Medicare Part D

• Part A Hospital care, automatic at 65
• Part B Other care, voluntary/premiums
• Part C Managed Care/HMOs
• Part D Prescription Drugs
• Subsidy for private insurance
• Doughnut hole and other complexities
• Penalty for delayed enrollment
• Dual eligibles

4
Rx Coverage Update

• 25 million Americans enrolled

5
Rx Coverage Update
6
Rx Coverage UpdateKaiser Family
Foundation/Harvard School of Public Health survey
Dec. 2006

• Too complicated, but saves most seniors money
• 2/3 strongly favor government negotiating for
  lower prices
• Bush opposes and Senate blocked legislation last
  week.
• Most favor eliminating late enrollment penalty
• 3/4 say personal experience positive
• http//www.kff.org/kaiserpolls/upload/7604.pdf

7
SCHIPState Children's Health Insurance Program

• Covers 6 million children
• Funding 70 Federal and 30 State
• Administered by States (according to Federal
  rules)
• www.insurekidsnow.gov state details
• Pending proposals and issues
• Reauthorization this year, bills now being
  introduced
• Funding shortfall threatens coverage of 2 million
• About 700 million dollars short for 2007
• Alliance for Health Reform Briefing
• http//allhealth.org/briefing_detail.asp?bi99

8
States Arent Waiting

• Arkansas
• Rhode Island
• Tennessee
• Vermont
• and Massachusetts
• RWJF State Coverage Initiatives
• http//www.statecoverage.net/programsinprogress/in
  dex.htm

9
Massachusetts MandatoryInsurance

• Everyone must have insurance by July
• Penalties, exceptions
• Subsidies - how much does it cost?
• Will other states follow?
• Whos responsible?
• Accidental employer-based coverage
• Govt. covers some, but not others
• (the worthy and the unworthy)
• What values are in play?

10
California

• Big State, Big Impact
• Proposals pending
• Governor Schwarzenegger's Plan
• AB 8 (Núñez)
• SB 48 (Perata)
• SB 236 (Runner)
• SB 840 (Kuehl)
• California HealthCare Foundation summaries
• http//www.calhealthreform.org/index.php