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Impact of Health Care Reform on Major Stakeholders

February 25, 2010 Karen Ignagni America’s Health Insurance Plans. Impact of Health Care Reform on Major Stakeholders. What Our Community Did to Prepare for 2009. Pivotal Board of Directors’ Decision Proposal in November, 2006 to Get All Americans Covered

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Impact of Health Care Reform on Major Stakeholders

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  1. February 25, 2010 Karen Ignagni America’s Health Insurance Plans Impact of Health Care Reformon Major Stakeholders

  2. What Our Community Did to Prepare for 2009 • Pivotal Board of Directors’ Decision • Proposal in November, 2006 to Get All Americans Covered • Proposal in March, 2007 to Improve Quality • Proposal in December, 2007 to Guarantee Coverage in Individual Market • Proposal in May, 2008 to Contain Costs • Summer “Listening Tour” • Proposal in November, 2008 for Individual Market Reform • Proposal in December, 2008 for Comprehensive Reform

  3. What Did We Propose Before the 2009 Debate Began and Why? • Guaranteed Issue • No Pre-existing Conditions Limitations • No Health Status Rating • No Gender Rating • Everyone Insured and Participating in the Risk Pool • Strengthening of the Safety Net • Help for Small Businesses • Subsidies for Working Families • Cost Containment

  4. Contributions During 2009 – In Addition to Market Reforms • Worked with Other Stakeholders on Effort to Create a National Commitment to Reducing Future Rate of Growth • Committed to Aggressive Requirements to Address Administrative Simplification • Committed to “Stabilization Fund” to Smooth Out Transition Costs for Individuals • Committed to Support Medicare Advantage Being Part of the Health Care Solution While Preserving Access Across the Country

  5. Why We Began to Develop Concerns • Erosion of Mandate • Significant Contraction of Rate Bands to a Level that Would Raise Costs Significantly for Young People. • Premium Tax Layered on Top of Stabilization Fund • Lack of Cost Containment in Legislation • IMAC Exempting Key Cost Drivers • Prospect of Medicare Cuts Exacerbating Cost Shifting • Missed Opportunities for Sustainable Payment Reform Throughout the System • MA Cuts that Would have Shut Down the Program in Certain Areas • Proposed Federal Premium Regulation that Doesn’t Address Cost Drivers

  6. Ten Opportunities for Common Ground • Insurance Reforms • Improved Safety Net • Cost Containment • Subsidies for Working Families • Payment and Delivery System Reform • Malpractice Reforms • Encouraging Prevention and Early Intervention • Administrative Simplification • State Exchanges • State Compacts

  7. How Do We Do It • Discuss Responsibility of all Stakeholder Groups • Discuss How Containing Costs Can Offset the Price Tag of Reform, Phase-in Coverage Requirements and Fund Necessary Subsidies • Discuss How to Jump Start Payment and Delivery System Reform

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