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Healthcare 2014

Healthcare 2014. North Coast Association of Health Underwriters September 10, 2014 Grace-Marie Turner, Galen Institute. Current ACA Coverage Estimates. 25 million more to get health coverage + 13 million through Medicaid expansion

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Healthcare 2014

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  1. Healthcare 2014 North Coast Association of Health Underwriters September 10, 2014 Grace-Marie Turner, Galen Institute

  2. Current ACA Coverage Estimates 25 million more to get health coverage + 13 million through Medicaid expansion + 24 million through federally subsidized private insurance - 12 million lose current coverage 31 million remain uninsured by 2023 Source: http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900-2013-05-ACA.pdf

  3. 2015 Reenrollment challenges Goal: Keep “8 million” and enroll 5 million more Automatic reenrollment But many of 87% getting subsidies could face higher costs, lose added Silver plan subsidies Subsidies tied to second-lowest priced Silver plan or “benchmark” plan Costs for individuals could rise significantly

  4. CALIFORNIA • Sonoma County • Pre- to Post- ACA rates • MEN • Age 27 $128 to $217 70% • Age 40 $162 to $265 64% • Age 64 $509 to $623 22%

  5. California battles over rates Proposition 45 - Commissioner Dave Jones/Consumer Watchdog 70% of voters support state rate regulation Weighted average of CCA rates : +4.2% in 2015 ACA reinsurance program helps stem losses – but ends in 2016. Insurers are hit with higher admin costs, MLR rules, new taxes, and soaring hospital costs Explain that consumers will be harmed with even narrower networks, higher OOP cost

  6. Are most ACA subsidies even legal? U.S. Court of Appeals in Washington, DC 2-1 decision The language of the ACA “unambiguously restricts” subsidies to “Exchanges established by the state.” U.S. Court of Appeals in Richmond 3-0 decision “…widely available tax credits are essential to fulfilling the Act’s primary goals.”

  7. Court challenges will continue En banc hearing by full D.C. Circuit Court of Appeals Two more federal courts will rule on similar challenges Indiana Oklahoma Split decisions will send the case back to the Supreme Court A decision against the government will require action by Congress to protect 5+ million people receiving subsidies

  8. Close to a third of voters either received a cancellation notification or know someone who did. Future “worriers” more closely related to opposition BASE: ALL QUALIFIED RESPONDENTS Q705. For each of the following, indicate Yes or No.

  9. More than two-thirds of voters believe we should address health care policy in a step-by-step approach COMPREHENSIVE 31% STEP-BY-STEP 69% Parker believes we should address health care policy improvements in a step-by-step approach so that we focus on the biggest problems first and avoid making changes that may bring unintended consequences or upset our coverage or other things we like in the current health care system. Riled-Up Individualists: 89% Oppose Obamacare: 84% Conservatives: 84% Republicans: 83% Discouraged Conservatives: 81% Tea Party supporters: 80% HS or less education: 75% Ages 35-54: 74% Alienated Liberals: 74% Davis believes that comprehensive legislation is the only way to bring about real health care reform. Health care issues are complex and interconnected. The comprehensive approach is the best way to deal with these issues all together to achieve the real changes that are needed. Liberal Left: 55% Support Obamacare: 54% Liberal: 50% Democrats: 47% Hispanic: 44% Ages 27-34: 41% Black: 40% Post grads: 38% BASE: ALL QUALIFIED RESPONDENTS Q235. Please read each opinion and indicate which one comes closest to your own:

  10. Majority of voters would prefer to try a new alternative to Obamacare or go back to the old system If it were up to you to make a decision about Obamacare, which would you choose? Most likely to want to try a new alternative: Alienated Liberals: 49% Discouraged Conservatives: 43% Riled-Up Individualists: 42% Republicans: 41% HS education or less: 40% Conservatives: 40% Not employed: 39% Independents: 39% Mostly likely to want to keep Obamacare Liberal Left: 80% Democrats: 68% Liberals: 69% Black: 62% Moral Citizens: 53% Hispanic: 48% West: 47% Post grads: 47% Ages 27-34: 46% Moderates: 43% Most likely to want to go back to old system: Riled-Up Individualists: 54% Tea Party supporters: 51% Republicans: 50% Discouraged Conservatives: 45% Those receiving coverage cancellation notices: 35% South East: 35% HS education or less: 34% Ages 18-26: 33% BASE: ALL QUALIFIED RESPONDENTS Q275. Thinking about things a little differently, if it were up to you to make a decision about Obamacare, which would you choose?

  11. What’s next with health reform?

  12. Two different visions

  13. “We need to pass our own replace bill to show what we are for”

  14. Providing help to buy health insurance • Tax deduction? • How much? • Tax credit? • Refundable? • Advanceable? • Age adjusted? • Targeted? • Tax cap? • What level? Difficult choices

  15. Start by painting a new vision …not by first getting bogged down in these hard choices and difficult details

  16. Moving to a Patient-Centered Health Care Sector Private sector • Align incentives • Transparency • Genuine competition • Benefit choices • Pre-existing condition protection • Nurture innovation Public sector • Choice of private plans in Medicare • Escape from the Medicaid ghetto • More flexibility and incentives for states to take the lead on reform

  17. Coburn/Burr/Hatch Patient Choice, Affordability, Responsibility and Empowerment Act Broun Patient OPTION Act Scalise/Roe The American Health Care Reform Act Price Empowering Patients First Act

  18. Genuine choice, better coverage through real competition

  19. Patients and doctors make decisions

  20. Making insurance at work more affordable

  21. More stability for Medicare

  22. Giving the poor more options

  23. Holding hospitals accountable

  24. Focus groups with independent women

  25. Make policy personal and relevant Examples…

  26. A young mother • Pick your own plan and doctors

  27. A young, single guy • Affordable catastrophic coverage

  28. A small business owner • Choices of plans she can afford

  29. Someone with chronic or serious illness • A strong safety net

  30. Conveying a fresh vision of health freedom More choices of more affordable coverage that lets you pick your own plan, your own hospital, and your own doctor Straightforward guarantees you can keep your coverage A safety net that protects the vulnerable and those with pre-existing conditions

  31. Joint public/private initiatives • Using claims data, EHRs to gather information to improve consumer engagement • Cost transparency +incentives for consumers to shop wisely • Consumer priorities in selecting plans: Price. Access. Brand. • Access to providers via phone, email, and social media • Hot buzz-terms: • Value-based payment • Channeled partnerships • Vertical integration (ACOs) to share risk and rewards

  32. Repeal Replacewith Bipartisan Reform

  33. Grace-Marie Turner Galen Institute 703-299-8900 gracemarie@galen.org Twitter @GalenInstitute @gracemarietweet Facebook GalenInstitute Subscribe to our free email alerts at www.galen.org/subscribe

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