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Delaware Health Care Commission February 17, 2005 Alice Burton, Director AcademyHealth. FY 2006 Budget Highlights. Pledge to reduce deficit in half by 2009 Record deficit of $427 billion Non-security, discretionary spending will rise 1%
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Delaware Health Care Commission February 17, 2005 Alice Burton, Director AcademyHealth
FY 2006 Budget Highlights • Pledge to reduce deficit in half by 2009 • Record deficit of $427 billion • Non-security, discretionary spending will rise 1% • However, HHS will decrease discretionary funding by 1.2% • 17% increase in Medicare - Revised cost estimates for Medicare Modernization Act
President Bush’s Health Agenda • Economic opportunity and ownership • Health Information Technology • Comprehensive, consumer driven health care: HSAs, tax credits, Association Health Plans and medical liability reform • Compassionate Society • Providing access through Health Centers • Medicaid and SCHIP • Protecting America • Making government more effective Source: Overview of Presidents 2006 Budget, OMB 2/7/05
President Bush Coverage Agenda • Health Insurance Tax Credit • Health Savings Accounts • Tax credit • Above the line deduction • Rebate to small employers • State Purchasing Pools • Association Health Plans (AHP’s) • SCHIP outreach • Community Health Centers Source: Overview of Presidents 2006 Budget, OMB 2/7/05
Medicaid Proposals • Secretary Leavitt identified $60 billion in cuts over ten years • Eliminating Inter-governmental transfers (IGT’s): $40 billion • Fraud and Abuse: $5 million • Amend Medicaid Drug Rebate Formula: $15 million • Medicaid and SCHIP modernization
Delaware Health Commission Project Guiding Principles • Highest ratio of dollars to insured • Target policy at low income populations • Administratively feasible • Avoid entanglement with federal law • Build on older programs and successful structures
Policy Options 2004 Strategic Plan • Limited Benefit Plan • One-Third Share Plan • Delaware Healthy Children Expansion • Purchasing Pool
Limited Benefits Plan • Low Cost Insurance product or direct reimbursement emphasizing primary and preventative care • Program can be targeted at low income • Affordable for low income individuals via minimal cost sharing
One-Third Share Plan • Employer, employee, and the state each pay one-third of total premium • Streamlined benefit package • Affordable “coverage” for the working uninsured employed by small businesses
Delaware Healthy Children Expansion • Expand Delaware CHIP program to cover parents of Medicaid and CHIP eligible children between 100% FPL and 200% FPL • 1115 HIFA Waiver allows state additional freedom for benefit , cost-sharing, and enrollment caps
Purchasing Pool • Pool negotiates with private carriers and determines which plan to offer • Employers pay minimum premium percentage and enroll a minimum percentage of employees • State absorbs adverse selection with subsidy