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Health Care Reform – Current Activity

Health Care Reform – Current Activity. Randy Kammer, VP, Regulatory Affairs and Public Policy . Current Environment. Administration and Democratic Leadership have increasingly moved from Health CARE Reform to Health INSURANCE Reform Guaranteed issue and renewal

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Health Care Reform – Current Activity

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  1. Health Care Reform – Current Activity Randy Kammer, VP, Regulatory Affairs and Public Policy

  2. Current Environment • Administration and Democratic Leadership have increasingly moved from Health CARE Reform to Health INSURANCE Reform • Guaranteed issue and renewal • No medical underwriting or pre-existing condition requirements • Premiums -- Vary only by family composition, benefit value geography, and age no more than 2:1 (7.5:1 in Senate Finance framework) for individual and small group markets • No annual or lifetime limits • Loss ratio reporting requirements or rebates

  3. Current Environment • Congress using investigative authority to quash dissent • Representative Waxman (Energy & Commerce Committee) • Senator Rockefeller (Commerce, Science & Transportation) inquiry • Representative Kucinich (Government Oversight Subcommittee) hearings • Misinformation abounds • Passions run high on all sides as evidenced by disruptions in town hall meetings • Less focus on substance – little focus on true cost reductions

  4. Current Environment (con’t) • Efforts at bipartisanship appear to be fading • “Gang of Six” Democratic Senators Baucus, (Montana), Bingaman (N.M.) and Conrad (N.D.), Republican Senators Grassley (Iowa), Snowe (Maine) and Enzi (Wyoming) released framework of proposed legislation • Continued assertion that government plan is necessary to counteract perceived insurance “abuses” • Ten million energized and connected advocates (HCAN) using public forums, commercials and daily email “messages” • Division among employers and trade associations regarding mandates • Congress and Administration still seeking Bill before end of 2009

  5. Blue Cross and Blue Shield of FloridaVision of Reform • Universal coverage (95% of Americans receiving access to appropriate health services) (Public/Private partnership) • Enforceable Mandates • Individual • Employer • Malpractice Reform • Changes to delivery system – Let government lead the way with expanded safety net paid by global capitation • Illness model to wellness • Evidenced Based Medicine • Expanded safety net (for everyone below 250% of federal poverty level) • Incentives for a healthier population • Personal responsibility

  6. Congressional Budget Office • Cost estimates for proposed health reform legislation range from $1 trillion to $1.6 trillion (Senate Finance Committee has initial estimate of $800-$900 billion over 10 years) • Administration states they want deficit neutrality • Senate Finance Committee framework annual “fees” • $6 billion on Health Insurance Industry • 35% excise tax on insurers for high cost plans • $2.3 billion on pharmaceutical manufacturing industry • $4 billion on medical device manufacturers • $750 million on clinical laboratories • Other revenue sources • $500 billion in Medicare Advantage savings • $113 billion from increased excise taxes on sugar-sweetened and alcoholic beverages

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