House Health Care “Reform” Bill

1. House Health Care “Reform” Bill • Passed late Saturday night – 220-215 • Proposes to cover 36 million Americans currently without health insurance • Major expansion of Medicaid • Up to 150% of federal poverty level • Includes government health care option • Hospitals/providers negotiate rates with government insurer • Fine for individuals who do not purchase health insurance • Cost - $1 Trillion…1990 pages

2. House Health Care Reform Bill • Private insurers cannot deny/drop coverage • Increased income tax on those making more than $500,000 • Medicare expenditures cut by 1.3% • $15 billion falls on prescription drug industry • 2.5% tax on medical device manufacturers • “Medicine Cabinet Tax” on HSAs • Stupak Amendment • Prevents federal funding for plans that cover abortion

3. Concerns • Medicaid broken! • Why expand a program all agree is broken? • States pick up almost half the tab and it is required • This will force other programs to take a hit OR • Tax increases to fund the status quo • This has not worked in TN, MA…why do it?

4. Concerns • More people will move to government health care and thus COST-SHIFT • HSAs are weakened by this legislation • Medicare benefits are cut/Medicare Advantage undercut • Still leaves almost half of the uninsured untouched • Fines for those who do not insure

5. Concerns • Can we afford this 1,000,000,000,000.00? • Will mandates grow jobs? • When will these new programs be passed along to the states? • How many new government jobs are required to carry out this mandate? • How much will be spent before the first person is helped? • Tort Reform?

6. Other Ideas • 1996 Welfare Reform • Let states use existing dollars to come up with own plan • Give national government true cost control • Flexible on many fronts • Proven model • Allow states to be empowered • Removes mandates

7. Other Ideas • Help move people on margins from Medicaid to private • Instead of being on government program they move to their companies HMO/PPO • Allow people to purchase health insurance across state lines • Give tax credits to the individual instead of the company

8. Other Ideas • HSAs better than no insurance especially for the “invinceables” • Put cost of medical services on the wall • Barebones coverage instead of required mandates • More aggressive anti-fraud measures

9. Interest Groups • Insurance Companies • Hospitals • Doctors • Patients • Small Business Owners

10. Interest Groups • Insurance • Lose patients when they go to Medicare • Baby Boomers • Like • Required coverage means more patients to insure • Dislike • Public plans lure away customers • Regulation means higher prices • Tax “Cadillac” plans…

11. Interest Groups • Hospitals • Hurt by low Medicaid reimbursement • Lack of EMR • Like • EMR • Coverage for uninsured helps cut “charity care” • Stop doctors from ownership of hospitals • Dislike • Lower reimbursements for Medicare

12. Interest Groups • Doctors • Face high malpractice rates “defensive medicine” • Low reimbursement rates and lack of primary care • Likes • Loan forgiveness for primary care • Medical home compensation • Dislikes • Lower reimbursements • Less acute care means less business

13. Interest Groups • Small Business • More are dropping coverage due to increased cost • Likes • Buy into larger risk pool • Could be exempt from new plan if small enough (10-25 employees) • Dislikes • Forced health benefits in weak economy • Higher prices or let employees go due to costs