1 The following presentation is brought to you by the Member Firms of United Benefit Advisors in conjunction with the National Association of Health Underwriters The following presentation is brought to you by the Member Firms of United Benefit Advisors in conjunction with the National Association of Health Underwriters
The following presentation is brought to you by the Member Firms of United Benefit Advisors in conjunction with the National Association of Health Underwriters. - PowerPoint PPT Presentation
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
– Undocumented immigrants will not be covered– No public financing of abortions– If you like your plan you can keep it– Existing coverage will not change, just become better and less expensive– Public option, if there is one, will be limited to small employers and
uninsured individuals– Bill will not increase federal deficit by one penny– Bill will cost about $900 billion and be financed most through
administrative savings and cuts to waste, fraud and abuse in the current system
Still allowing Congressional lead in negotiations but staff is becoming more active behind the scenes
Will You Really Be Able to Keep Your Current Plan?
Despite the oft-repeated promise that if you like your current health insurance policy you can keep it, the bills under consideration all contain very strict grandfathering provisions
New plan rules include rating restrictions, an essential benefits package that is far “richer” than many current plans, new taxes on insurers and other aspects of the industry that will be passed to consumers, and a weak individual mandate
New AHIP/PWC study concludes that by 2019 the average family will be paying $4,000 a year more in premiums than they would without reform
Bills require all Americans to obtain specific levels of health insurance coverage
Intent is good—many uninsured are young and healthy, and inclusion in the insured risk pool would stabilize costs
Insurance carriers could underwrite policies without taking into account preexisting conditions and basing rates on health conditions if EVERYONE is in the system
Questions:– Costs of subsidies needed to make sure everyone can afford
coverage– What counts as qualified health benefits plan?– Is tax system effective enforcement? – If enforcement doesn’t work, what is the impact on costs?– Impact on Employer-Sponsored plans?
House Bill and Senate HELP Bill include outright mandates for employers to provide employees with coverage
Employers told what kind of coverage to offer, to whom they must offer it (including part time employees), and how much they have to pay
Would affect fully insured and self-insured plans (COBRA equivalence); effectively end ERISA preemption
If employers don’t comply with every specific of the mandate, they are fined, and the fine does not go toward the cost of coverage for employees
Exemptions for small employers (to a certain degree) from the mandate. President Obama promised employers of less than 50 will be exempt
Senate Finance Committee does not impose a direct mandate on employers to provide coverage. It requires employers of more than 50 people to pay a fine for low income employees who aren’t offered “affordable coverage” and instead obtain subsidized coverage through the exchange
All of the bills contain efficiency improvements, payment reforms and a greater focus on wellness and prevention
Almost all of the provisions targeted at public programs, not the private market
None include substantive tort reform—would extend jurisdiction over the bills to the Judiciary committees
Senate HELP and Finance bills include improvements to employer wellness programs, rating for wellness factors and tax incentives for employers that provide qualified wellness programs to their employees
Senate Finance mark is the most serious attempt to constrain rising health care costs to date, with provisions on disease prevention and wellness, improving the quality and efficiency of health care and value-based purchasing
CBO cost analysis of H.R. 3200 is $1.3 trillion dollars over 10 years
Not deficit neutral and “relative to current law, the proposal would probably generate substantial increases in federal budget deficits during the decade beyond the current 10-year budget window.”
House bill is financed by $400 billion in Medicare cuts, tax on high-end (expensive) employer sponsored plans and an income-tax surcharge on the wealthiest of Americans.
Senate HELP bill also scores over $1 trillion—no payment mechanism was included since this is not a committee with financial jurisdiction
Senate Finance bill score currently hovers around $840 billion—score is just an estimate because its not in legislative language
The Finance bill is funded with an excise tax on most “expensive” plans, and new taxes on health insurance plans, prescription drugs, and medical device manufacturers
− The excise tax is based on an arbitrary number that does not take geography or the higher costs experienced by older or sicker groups into consideration
− The excise tax may be calculated based on health, dental, supplemental benefits and FSAs
− New taxes on health insurance plans, drugs, and devices will be passed on as increased premiums.
Public concern about record deficit and added cost of health care reform, hopefully, may shape final legislation
Divisive opinions of liberal vs. centrist Democrats in both the House and Senate on issues such as a public option and financing could pose a roadblock to passage
Republicans are united in opposition to all bills, except Senator Snow’s “qualified” approval to Senate finance bill