Impact of Health Reform on: The Uninsured

1
Impact of Health Reform onThe Uninsured

• of uninsured reduced from 46 million today to
  23 million in 2019.
• Safety net hospital funding through Medicare cut
  by 36 billion through 2019.
• Community health centers receive extra 1 billion
  annually

2
Impact of Health Reform onThe Underinsured

• If you like your current coverage you can keep
  it.
• If you dont like your current job-based
  coverage, you HAVE to keep it.
• Policies required to cover at least 60 of
  expected health costs e.g. 2,000 deductible
  20 co-insurance for next 15,000 of care.

3
Impact of Health Reform onMedical Bankruptcy

• No change for 75 of medically bankruptcy filers
  who have insurance.
• Up to 50 reduction among the 25 of the
  medically bankruptcy who were uninsured in 2007
  but will gain coverage under reform.
• Maximum expected reduction in medical
  bankruptcies 12.5.

4
Impact of Health Reform onHealth Care Costs - 1

• Expanded Medicaid - 434 bil.
• Subsidies for private coverage - 358 bil.
• Small employer tax credits - 37 bil.
• Temporary high risk pools, subsidy for retirees
  lt65, etc 10 bil.
• All figures reflect spending
  through 2019

5
Impact of Health Reform onHealth Care Costs 2
(savings)

• Decreased Medicare Advantage/HMO overpayment -
  136 bil.
• Decreased Medicare (DSH) payment to safety net
  hospitals - 36 bil.
• Decreased Medicare fee-for-service payments to
  doctors/hospitals - 196 bil.
• Other Medicare/Medicaid cuts - 87 bil.
• All figures reflect spending
  through 2019

6
Impact of Health Reform onCost Control
Provisions

• Insurance exchanges
• Health information technology
• Comparative effectiveness research
• Fraud and abuse prosecution/recovery
• Alternatives to F-F-S (experiments)
• Coverage of preventive services
• Tax on Cadillac coverage
• Malpractice reform (experiments)
• Medicare advisory board

7
Health Reform BillProven Cost Control Provisions
8
Impact of Health Reform onAdministrative Costs

• IRS cost to enforce mandate - 5-10 bil
• Running insurance exchanges - 4 of premiums
  (based on Massachusetts)
• Insurance overhead - 13 of new premium revenues
  42 bil
• Cap on insurance overhead - ????
• Standardized claim forms - ????

9
Role Played by Health Industry in Health Reform

• Insurance donations to Dems Repubs ads in
  favoring AND opposing
• Pharma - gt100 million on ads supporting reform
• Senate framework written by Liz Fowler, former VP
  of Public Policy for Wellpoint/Anthem