HEALTH REFORM:

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HEALTH REFORM Taking our freedom back!
Virginia Tea Party Patriots October 9,
2010 Grace-Marie Turner Galen Institute
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Americans continue to agree on goals for health
reform

• The U.S. needs health reform to make coverage
  more affordable, increase quality, and expand
  insurance coverage
• Most people rate their own care as good or
  excellent
• They want stability. Change is for others.
• Now, strong majorities fear lower quality, higher
  costs, and difficulty accessing care

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Its Not Governments Job
Do you think it is the responsibility of the
federal government to make sure all Americans
have health care coverage, or is that not the
responsibility of the federal government? GALLUP
Source Newport, Frank. "More in U.S. Say Health
Coverage Is Not Govt. Responsibility." Gallup.
13 Nov 2009. Gallup, Web. 27 Jan 2010.
lthttp//www.gallup.com/poll/124253/Say-Health-Cove
rage-Not-Gov-Responsibility.aspxgt.
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But new law does call for a much bigger role for
government

• 32 million more to get health coverage
• 16 million through Medicaid expansion
• 16 million through federally subsidized state
  exchanges
• 23 million remain uninsured in 2019
• Strict federal regulation of health insurance
• Mandates on individuals and employers
• 500 billion in new taxes and penalties
• 575 billion in cuts to Medicare

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Health law fails to match promises

• Health costs and health spending increase
• Millions more will lose their private coverage
• One-third of businesses could drop insurance
• Few changes to modernize care delivery, reduce
  defensive medicine, or provide more choices of
  more affordable coverage.
• Successful programs like Medicare Advantage on
  the chopping block payment cuts threaten access
  to care for seniors

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True Cost 2.4 trillion

• Cost of health reform over 1st 10 years

For 2.4 trillion, youll need to make about 6 ½
laps around the world
CNBC http//www.cnbc.com/id/30108264/What_Does_1_
Trillion_Look_Like?
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Independent Studies

• Obama administration actuary Richard Foster
• 120 billion in fines for companies and
  individuals
• Government spending will increase by 311 billion
• One in five Medicare providers go broke
• CBO ObamaCare will raise some family premiums
  by 2,100 in 2016 above what they would have been
  without the reform law

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The health law is not settled policy

• 50 - Want the health overhaul law repealed
• 51 - Say it will reduce the quality of care
• 56 - Object to cuts to Medicare
• Two-thirds say it will increase the national debt
• 60 believe it will increase health costs
• Just 12 think the bill should go into effect in
  its current form
• 71 say it will increase taxes

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Push-back coming from

• Small businesses and big employers New costs,
  penalties, and mandates1099
• Workers Losing health insurance at work
• Doctors and patients Losing control over medical
  decisions IPAB and CER
• Costs Early sweeteners are already increasing
  health insurance costs
• Seniors 575 billion in cuts to Medicare

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Consequences for the states

• 41 states have are challenging ObamaCare
• 20 states opt out of federal high-risk pools
• Ballot challenges Nov. 2 in Colorado, Oklahoma,
  and Arizona
• 71 in Missouri voted to opt out of law
• Many states see huge costs of mandates

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ObamaCare Skyrocketing Enrollment
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Putting the Brakes on ObamaCare

• Defund it Dont hire an Army of IRS agents
• Dismantle it 1099 requirement CLASS Act
• Delay it Medicare Advantage
  mandates 500 billion in taxes
• Disapprove regulations Sen. Enzi/
  Congressional Review Act
• Direct oversight and investigation Hearings on
  escalating spending and impact on business
• Delegate to the states Medicaid block
  grantsHealthy Indiana Plan Utah Health Exchange

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Some realities
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 Source Mercer's National Survey of
Employer-Sponsored Health Plans Bureau of Labor
Statistics, Consumer Price Index, U.S. City
Average of Annual Inflation (April to April)
1990-2009 Bureau of Labor Statistics, Seasonally
Adjusted Data from the Current Employment
Statistics Survey (April to April) 1990-2009.
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What we know for sure

• CHOICE Americans value innovation, diversity
  and choice to accommodate 300 million people
• FOCUS ON THE PATIENT They want doctors and
  patients, not government, to make health care
  decisions
• CONCERNS ABOUT COSTS This is a huge,
  far-reaching law that will swell the deficit and
  threatens to destroy quality care

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Starting a fresh conversation

• Engaging patients as partners in managing health
  costs and getting the best value for health care
  dollars
• FREEDOM in care and coverage

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R-E-P-E-A-L

• Repeal ObamaCares massive new taxes 
• Eliminate job-killing mandates on businesses
• Protect citizens from IRS enforcers by repealing
  the individual mandate
• Eliminate cuts in benefits to seniors on Medicare
  Advantage
• Avoid crippling the states with expensive
  mandates
• Limit government intrusion into personal medical
  decisions

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R-E-P-L-A-C-E

• Real help for people to purchase health insurance
  they choose  
• Expand states ability to help people with
  pre-existing conditions  
• Put Medicare savings into saving Medicare 
• Lawsuit abuse reform 
• Allow doctors and patients to control medical
  decisions 
• Control costs though consumer-friendly health
  reform 
• Expand access through cross-state purchasing of
  health insurance

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States Rights Initiatives

• Healthy Indiana Program
• Texas medical malpractice reform
• Utah Health Exchange
• Idaho guaranteed access plan
• Massachusetts What not to do

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The future?

• The global move toward consumerism is real,
  driven by greater patient demand for more control
  over decisions.
• Health overhaul is law and will fundamentally
  change our health sector. Our job is to repeal
  and replace it before it takes effect in 2014.

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Opportunities ahead

• This is not settled policy
• Two major elections before implementation
• States and governors will have a big say
• Lawsuits will reach the U.S. Supreme Court
• The American people want
• Freedom Options Control
• This law must be repealed!

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• Contact
• Grace-Marie Turner
• Galen Institute
• [phone]
• gracemarie_at_galen.org
• www.Galen.org
• www.HealthReformHub.org

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ObamaCare Restricted Access

• Medicaid is now the only option for low-income
  Americans.
• 40 of doctors restricted access to Medicaid due
  to low reimbursement rates.
• 50 of doctors accept new Medicaid patients
  compared with the 70 that accept new Medicare
  patients.
• 2/3 of ER frequent fliers were covered by
  Medicaid/Medicare.

• Medicaid patients are twice as likely as the
  uninsured, and five times as likely as the
  privately-insured, to be an ER frequent flier.
• Medicaid patients are twice as likely as the
  uninsured, and four times as likely as the
  privately-insured, to use the ER.

Sources Office of Senator Tom Coburn, Annals of
Emergency Medicine, National Center for Health
Statistics
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ObamaCare Poor Health Outcomes

• Medicaid patients who need surgery are 13 more
  likely to die than the uninsured, and 97 more
  likely to die than those with private insurance.
• Medicaid patients are 50 more likely to die
  after bypass surgery because of poor follow-up
  care.
• Medicaid patients with cancer are two to three
  times more likely to die from the disease.

• Medicaid mothers received less prenatal care and
  had higher infant mortality rates than those with
  private insurance.
• Florida Medicaid patients are 31 more likely to
  have late-state breast cancer, and 81 more
  likely to have late-stage melanoma.

Sources Heartland Institute, Wall Street
Journal, Office of Senator Tom Coburn, National
Review Online
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Fighting Back Florida v. U.S. DHHS

• 16 AGs (FL, SC, NE, TX, UT, LA, AL, CO, PA, WA,
  ID, SD, IN, ND, AK, MI)
• Four governors (MS, AZ, NV, GA) and NFIB
• March 23 Initial complaint filed in Northern
  District Court of FL
• June 16 Feds file motion to dismiss
• September 14 Oral arguments before Judge Roger
  Vinson
• October 14 District Court decision on motion to
  dismiss
• December 16 Hearing on summary judgment
• MAJOR ARGUMENTS
• Congress cant compel the states to assume
  unfunded mandates levied in PPACA
  (Commerce/Guarantee Clauses)
• The states cant be commandeered to administer
  and fund the health insurance exchanges (10th
  Amendment)
• The states cant be forced to expand their
  Medicaid programs at significant cost to the
  states (Article I, Sections 2 and 9)
• The individual mandate is unconstitutional
  (Commerce Clause)

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Real Reform Floridas Medicaid Pilot

• 2005 Medicaid reform pilot went live in Broward
  Duval Co.
• 2007 Medicaid reform pilot went live in Baker,
  Clay, Nassau Co.
• Insurance companies compete in Medicaid
  marketplace
• Beneficiaries get core benefits and choose
  customized ones
• Workers can opt-out and get premium assistance
  for ESI
• Healthy behaviors earn money in Enhanced Benefit
  Accounts
• Multilingual choice counselors help
  beneficiaries pick a plan
• THE RESULTS
• Beneficiaries can choose from up to 12 competing
  plans
• Plans are offering benefits not covered by
  Medicaid
• 80 of benefit packages dont require a copayment
• 80 of beneficiaries are voluntarily choosing
  their own plan
• 97 of beneficiaries are satisfied with choice
  counseling

Source Florida Agency for Health Care
Administration