National Health Care Reform: What is it and What Does it Mean to You?
1. National
HEALTH CARE REFORM
What Is It and What Does It Mean To You?
Robert R. Pohls
Pohls & Associates
1550 Parkside Drive, Suite 260
Walnut Creek, California 94596
T: 925.973.0300 F: 925.973.0330
E-mail: rpohls@califehealth.com
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
2. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
March 23, 2010 Patient Protection and
Affordable Care Act
March 30, 2010 Health Care and Education
Reconciliation Act of 2010
What Is It and What Does It Mean To You?
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
3. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Karen Davenport, MPA
Director of Health Policy
Center for American Progress
Previously
♦ Washington Director, Medicare Rights Center
♦ Sr. Program Officer, Robert Wood Johnson
Foundation
♦ Member, White House Health Care Reform
Task Force
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
4. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Robert Moffit, Ph.D.
Director, Center for Health Policy Studies
The Heritage Foundation
Previously
♦ Senior Official, DHSS and OPM
♦ Framed The Heritage Foundation’s Response
to Pres. Clinton’s Health Care Reform Plan
♦ Helped Develop the Massachusetts Health
Insurance Reform Initiative
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
5. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Robert Smoldt, MBA
Chief Administrative Officer, Emeritus
Mayo Clinic
Assoc. Director, Health Care Policy Program
Arizona State University
Previously
♦ Chair, Department of Planning & Public Affairs
♦ Board of Trustees
♦ Executive Committee
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
6. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Series of Questions
♦ How did we get here?
♦ What do we have?
♦ When and how will we feel it?
♦ Will it work?
♦ What will it cost and who will pay?
Closing Remarks
Questions from the Audience
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
7. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
“. . . the hazards of sickness, accident, invalidism,
involuntary unemployment, and old age should be
provided for through insurance. This should be a
charge in whole or in part upon the industries, the
employer, the employee, and perhaps the people
at large. “ Teddy Roosevelt (August 1912)
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
8. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
9. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
QUESTION: How did President Obama succeed,
where others before him failed?
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
10. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Bipartisan Health Care Summit
Blair House -- February 25, 2010
♦ Preventing waste and fraud
♦ Medical malpractice reform
♦ Reforming the insurance market
♦ Giving individuals choices
♦ Small businesses insurance pools
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
11. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Bipartisan Health Care Summit
Blair House -- February 25, 2010
♦ Preventing waste and fraud
♦ Medical malpractice reform
♦ Reforming the insurance market
♦ Giving individuals choices
♦ Small businesses insurance pools
Further Exploration:
♦ Undercover investigations of health care providers
♦ Grants for alternatives to medical malpractice lawsuits
♦ Increasing Medicaid payments to doctors
♦ Expanding Health Savings Accounts (HSA’s)
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
12. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Affordable Care Act -- Reforms
♦ Alters rules for private health insurers
♦ Creates health benefit exchanges
♦ Imposes new requirements on employers
♦ Mandates individual coverage
♦ Changes Medicare and Medicaid
♦ Commits $350 million to fighting waste, fraud and abuse
♦ Creates incentives for improving the quality of care
♦ Reforms the health care delivery system
♦ Modifies the tax code
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
13. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Affordable Care Act -- Reforms
♦ Alters rules for private health insurers
♦ Creates health benefit exchanges
♦ Imposes new requirements on employers
♦ Mandates individual coverage
♦ Changes Medicare and Medicaid
♦ Commits $350 million to fighting waste, fraud and abuse
♦ Creates incentives for improving the quality of care
♦ Reforms the health care delivery system
♦ Modifies the tax code
QUESTION: What will the Affordable Care Act
really change?
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
14. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Affordable Care Act – Implementation Schedule
♦ Medicare Part D coverage gap (start in 2010; continue to 2020)
♦ Small employer tax credits (2010); Large employer tax penalties
(2014)
♦ Reforms physician payment models (2012)
♦ Tax penalties for individuals without qualifying coverage (2014)
♦ Increases minimum income eligibility level for Medicaid (2014)
♦ Creates health benefit exchanges (2014)
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
15. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Affordable Care Act – Implementation Schedule
♦ Medicare Part D coverage gap (start in 2010; continue to 2020)
♦ Small employer tax credits (2010); Large employer tax penalties
(2014)
♦ Reforms physician payment models (2012)
♦ Tax penalties for individuals without qualifying coverage (2014)
♦ Increases minimum income eligibility level for Medicaid (2014)
♦ Creates health benefit exchanges (2014)
QUESTION: When -- and how -- will we feel the
effect of the Affordable Care Act?
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
16. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Affordable Care Act – Primary Objectives
♦ Containing soaring medical costs
♦ Covering more uninsured people
♦ Producing better results for patients
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
17. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Affordable Care Act – Primary Objectives
♦ Containing soaring medical costs
♦ Covering more uninsured people
♦ Producing better results for patients
QUESTION: Will the Affordable Care Act
achieve those goals?
♦ If so, how?
♦ If not, what more must be done?
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
18. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Congressional Budget Office -- Estimates
♦ Number of uninsured will be reduced by 32 million (2019)
♦ 24 million people will obtain coverage through health insurance
exchanges (2019)
♦ 16 million morepeople will enroll in Medicaid and Children’s
Health Insurance Program (2019)
♦ Projected Costs:
CBO: $938 billion (over 10 years)
White House: $100 billion saved (over 10 years)
$1 trillion saved (years 11-20)
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
19. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
QUESTION: Will the Affordable Care Act cost
America money or save America
money?
QUESTION: How will the costs of insuring more
Americans be paid?
QUESTION: Who will pay the costs?
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
20. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Judicial Challenges
♦ Thomas More Law ED Michigan ruled on 10/13/2010 that the
Center v. Obama individual mandate and penalties are
constitutional
♦ Commonwealth ED Virginia heard oral arguments
v. Sebelius on 10/18/2010; set to rule by 12/31/2010
♦ Florida v. DHHS ND Florida scheduled hearing for 12/16/2010
Mid-Term Elections
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
21. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Judicial Challenges
♦ Thomas More Law ED Michigan ruled on 10/13/2010 that the
Center v. Obama individual mandate and penalties are
constitutional
♦ Commonwealth ED Virginia heard oral arguments
v. Sebelius on 10/18/2010; set to rule by 12/31/2010
♦ Florida v. DHHS ND Florida scheduled hearing for 12/16/2010
Mid-Term Elections
QUESTION: What future challenges to health care
reform do you see?
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
22. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Karen Davenport, MPA
Director of Health Policy
Center for American Progress
Previously
♦ Washington Director, Medicare Rights Center
♦ Sr. Program Officer, Robert Wood Johnson
Foundation
♦ Member, White House Health Care Reform
Task Force
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
23. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Robert Moffit, Ph.D.
Director, Center for Health Policy Studies
The Heritage Foundation
Previously
♦ Senior Official, DHSS and OPM
♦ Framed The Heritage Foundation’s Response
to Pres. Clinton’s Health Care Reform Plan
♦ Helped Develop the Massachusetts Health
Insurance Reform Initiative
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
24. HEALTH CARE REFORM SPEAKERS FORMAT QUESTIONS REMARKS
Robert Smoldt, MBA
Chief Administrative Officer, Emeritus
Mayo Clinic
Assoc. Director, Health Care Policy Program
Arizona State University
Previously
♦ Chair, Department of Planning & Public Affairs
♦ Board of Trustees
♦ Executive Committee
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010
25. National
HEALTH CARE REFORM
What Is It and What Does It Mean To You?
Robert R. Pohls
Pohls & Associates
1550 Parkside Drive, Suite 260
Walnut Creek, California 94596
T: 925.973.0300 F: 925.973.0330
E-mail: rpohls@califehealth.com
2010 DRI Annual Meeting – San Diego Marriott Hotel & Marina – October 21, 2010