Social Media Presentation for Ohio Society of Healthcare Consumer Advocacy
© Ascension Health System Office Advocacy and Access Department, August 2009 Healthcare Reform...
-
Upload
anastasia-shields -
Category
Documents
-
view
217 -
download
0
Transcript of © Ascension Health System Office Advocacy and Access Department, August 2009 Healthcare Reform...
© Ascension Health System Office Advocacy and Access Department, August 2009
Healthcare Reform Update:Healthcare That Leaves No One Behind
2
A Historic Time for Healthcare Reform
© Ascension Health System Office Advocacy and Access Department, 2008, Beth Fuchs author
1930s & 1940s•Private Health
Insurance•Employee
Benefits•State Insurance
Regulation•Hospital
Construction•Universal
Coverage Fails
1980s•Reconciliation
Bills Initiated•Full Risk Plans
Enter Medicare•Medicare
Prospective Payments
•Means Testing for Catastrophic Benefits
1990s•HIPAA•FAS 109 (Retiree
benefits)•State Child Health
Insurance Program
•Universal Coverage Fails -- Again
2000 -- Present•Medicare Drug
Benefit•More Incentives
for Private Plans•Quality
Reporting/Payment
•Patient Safety•New
Administration•Health Care
Coverage Redefined as an Economic Issue
•Stakeholders Blink
1960s •Medicare &
Medicaid•Community
Health Centers
1970s National Health
Planning (CON)•ERISA •HMO Act•Price/Hospital
Cost Controls•Congressional
Budget Act•Universal
Coverage Fails -- Again
3
What, and For Whom, is 100% Access and 100% Coverage?
100% access and 100% coverage means that all persons, particularly those persons who are uninsured or underinsured, receive healthcare services and health insurance that:
2020 Goal and Associated Strategies ofHealthcare That Leaves No One Behind
1. Creates and supports the best journey to improved health outcomes for each individual, and
2. Is financed in an adequate and sustainable fashion.
National Legislative Leader
National Public Policy
Partner
Access Model
Catalyst
Voice of the
Voiceless
2020 Goal
Strategies
© Ascension Health System Office Advocacy and Access Department, August 2009
4
Our Guiding Features of a Reformed Healthcare Policy
Ensure 100% Access
to Healthcare Services
Achieve Destination of 100% Coverage
Reform Insurance Rules; Shared Obligation and
Responsibility for Coverage
Make Health Insurance
Affordable and Equitable
Eliminate Coverage and Service Gaps, Particularly for
the Vulnerable
Ensure Economic Viability Through Shared Financial
Responsibility
Improved Health for Our Community
We are committed to redesigning the healthcare delivery system
and partnering with policymakers
to achieve 100% access and 100% coverage.
Approved by Ascension Health Board of Trustees, December 2007© Ascension Health System Office Advocacy and Access Department, August 2009
Ascension Health’s Guiding Feature
Congressional Health Reform Proposals
Ensure 100% Access to Healthcare Services
The bills include delivery system initiatives to improve quality, value and transparency, and seek to improve patients’ capacity to navigate the healthcare delivery system. Ascension Health will continue to monitor proposals to assure that the role of the federal government in delivery system initiatives is to accelerate the delivery system’s effectiveness.
Achieve Destination of 100% Coverage
The Administration and Congress have set as a reform goal coverage for all (excepting undocumented immigrants). Coverage expansions are expected to begin as of 2013, with the target of 97% coverage in all bills. Premium subsidies at 400% of the federal poverty line in the House bills would provide needed assistance to many low income Americans to purchase health insurance. Ascension Health will continue to offer constructive policy options leading to 100% access, recognizing, however, that staging may be needed in order to be sustainable.
Reform Insurance Rules: Shared Obligation and Responsibility for Coverage
The bills include reforms in the individual and group markets to require guaranteed issue, eliminate pre-existing condition exclusions, and limit price differences based on health status. Bills include a version of an individual and employer mandate to purchase and offer insurance respectively. Ascension Health will continue to support financing options that spread burdens fairly and do not harm our most vulnerable citizens.
Make Health Insurance Affordable and Equitable
All the bills include rating rules and other insurance reforms as referenced above. All include premium and cost sharing subsidies to help lower-income Americans purchase health insurance and medical services. All will likely require benefit packages to meet a minimum level of coverage and reasonable cost sharing. Ascension Health will continue to scrutinize the details of the proposals to assess where affordability gaps may be found.
Eliminate Coverage and Service Gaps, Particularly for the Vulnerable
Medicaid expansions are a part of each reform proposal. The benefit package includes key services such as mental health and pharmaceuticals which are critical for vulnerable populations. The provision for adequate and ongoing safety net funding will continue to be a concern.
Ensure Economic Viability Through Shared Financial Responsibility
The proposals rely on a variety of techniques to fund coverage expansions that require individual, employer, physician, hospital and insurance company participation in funding. Ascension Health will seek financing solutions that share the financing burden in a fair and sustainable way.
100% Campaign: Ascension Health’s Guiding FeaturesCompared to the Health Reform Bills Under Consideration
August – Early September 2009
© Ascension Health System Office Advocacy and Access Department, August 2009
6
Health Reform Timeline
February March
March 24: Insurers release letter supporting guarantee issue coupled with an
individual mandate
March 27: Health Reform Dialogue group (“strange
bedfellows”) issues reform recommendations
Feb 4: President Obama signs HR 2,
the Children’s Health Insurance
Reauthorization Act of 2009 (CHIPRA),
expanding coverage for 4 million children
at a cost of $30 billion paid with
tobacco tax
Feb 17: HR 1, the American Reinvestment
and Recovery Act, is passed and includes $150 billion in new
healthcare spending
Feb 24: President Obama releases FY 2010 Budget that includes $634 billion
reserve fund for health reform
© Ascension Health System Office Advocacy and Access Department, August 2009
7
Health Reform Timeline
April May
May 7: President Obama issues 8 principles for healthcare reform;
New Democrat Coalition (progressive House Ds) release
“Prescription for Health Care Reform”
May 8: Blue Dog Coalition (fiscal conservative House Ds)
issue “Principles for Health Care Reform”
April 2: House and Senate
Budgets passed (without GOP support) with
“deficit-neutral” health reform
reserve fund and back-up reconcil-
iation clause
April 8: Executive Order signed establishing new
White House Office of Health Reform
May 6: Health Care Solutions Group (GOP) – “Vision of Health
Care Reform” released
April 28: Senate Finance Committee releases policy options
for transforming healthcare delivery system
© Ascension Health System Office Advocacy and Access Department, August 2009
8
Health Reform Timeline
May
May 20: Patients’ Choice Act of 2009 (Republican alternative) is introduced
by Senators Burr (R-NC) & Coburn (R-OK) and Reps.
Ryan (R-WI) & Nunes (R-CA)
May 11: Finance Committee
releases policy options to expand
healthcare coverage
May 13: President Obama meets with Speaker Pelosi, who pledges
to have a health reform bill out of the House before August recess
May 11: President Obama hosts the “Gang of Six” at the White House;
Stakeholders agree to “voluntarily” reduce healthcare costs by
1.5% over 10 years (AHA,AHIP, PhRMA, AMA,SEIU, AdvaMed)
May 18: Senate Finance Committee releases policy
options to finance healthcare reform
© Ascension Health System Office Advocacy and Access Department, August 2009
9
Health Reform Timeline: Looking Ahead
June July
Late July-Early September: House E & C passes health reform legislation 7/31.
House to bring legislation to the floor vote as early as the week of 9/7
June 1- June 12: HELP
Committee draft released 6/9;
HELP & Finance Cmte. Member
Walk-thrus. President
Obama meets with Dem.
Leadership to finalize timeline
for reform
Week of June 15: HELP markup beginning 6/17; Finance Cmte.
continues deliberations. House draft bill released June 19.
July 14 - House releases “America’s Affordable Health Choices Act of 2009. July
15 - Senate HELP Committee reports out comprehensive health bill. Senate Finance
continues deliberations in search of bipartisanship.
July 17- W&M and Ed. & Labor pass House reform legislation out of committee
Mid September-October ’09: Finance committee to release bill by September 15. Senate aiming for floor vote by early October. Congress aiming for Final vote on conference report to meet President Obama’s deadline for a bill “on the desk” by the end of October.
August September/October
© Ascension Health System Office Advocacy and Access Department, August 2009
10
Status of Health Reform BillsStatus of Health Reform Bills Moving Through Congress
Senate HELP (Health, Education, Labor and Pensions) Committee
Kennedy bill, not yet numbered, approved 13-10 on 7/15/09.
Senate Finance Committee Senators Baucus, Grassley, Conrad, Bingaman, Enzi and Snowe (the “gang of six”) continue to try to develop a bipartisan draft proposal. Timing of committee action unclear.
Full Senate Timing unclear. Democrats may have to use the budget reconciliation procedures to avoid GOP filibuster.
House Education and Labor Committee HR 3200, as amended, approved 26-22 on 7/17/09.
House Energy and Commerce Committee HR 3200, as amended, approved 31-28 on 7/31/09.
House Ways and Means Committee HR 3200, as amended, approved 23-18 on 7/17/09.
House Rules Committee Will work with Democratic Chair and Leadership to produce a melded version of HR 3200 for a floor vote.
Full House Vote possible in late September.
Conference Committee of the Senate and House
???
House and Senate chambers vote approval of conference report
In time for House and Senate adjournment in late 2009.
Presidential signature ???
Sen
ate
Hou
seJo
int
Pre
si-
den
t
© Ascension Health System Office Advocacy and Access Department, August 2009
11
Post Health Reform
Opportunities ChallengesAmericans Access to Affordable Health Insurance
Focus on Prevention, Primary Care to Improve Health Transparency to Improve Personal Responsibility
Unknowns on New Costs/Taxes to Consumers
Individuals with Rich Benefit Packages May See Changes
Young People May See Premiums Increase
Self-insured Employers
ERISA Plans Untouched Tax on Employee Benefits Above $ Value
Future Premium Cost Shift?
Small Businesses
Employees Gain Access to Affordable Insurance Mandate to Offer / Contribute
Healthcare Services
Patients Have Access to Insurance Charity Care/Bad Debt Obligations Contained
Future Payment Rates Unknown
Health Insurance Industry
Mandate to Purchase Insurance Pools Broadened New Customers
Insurance Rules Tightened Limits on Premiums Competition no Longer on Risk
Selection
Pharmacy Industry
Drug Coverage Likely Part of any Credible Coverage Expansion of 340B to Inpatient May Be Part of Health Reform
Pressure to Reduce Costs to Help Fund Health Reform
Government States Given Transitional Federal Assistance to Expand Medicaid
Federal Government will Lead Health Reform Parameters
© Ascension Health System Office Advocacy and Access Department, August 2009
12
Trajectory Towards Healthcare Reform
• Unwavering Presidential Intent
• Insurance, Drug, Hospital Interest Groups Began by Supporting Coverage Expansions and Insurance Reforms
• Democratic “Filibuster Proof” Majority
• Public Support for Healthcare Reform Due to Economic Realities Personalizing the Fear of Losing Health Insurance
• Healthcare Reform Defined as Democrat’s Agenda
• Country is Divided Politically and Vulnerable to Rhetoric
• State Healthcare Reform Efforts on Hold
• Momentum Stalled for Early Bill Passage
• Interest Groups are Positioning Their Business Interests for “Post-Reform” World and Beginning to Distract the Focus
• Political Stakes for the Republican Party May Trump Healthcare Issues
• CBO Has Not Scored Adequate Funding to Pay for Any Bill
© Ascension Health System Office Advocacy and Access Department, August 2009
13
System Influence:New Administration and
Congressional Leadership
Health Ministries’ Influence:
Congressional Delegation and
Governors
Partnerships, Coalitions, Forums
Voice to Maintain Momentum
The Role of Ascension Health Leaders
© Ascension Health System Office Advocacy and Access Department, August 2009
14© Ascension Health System Office Advocacy and Access Department, August 2009
15
Leaders’ Obligation
• Lead Health Reform Momentum– Statesmen and Stateswomen
• Raise Positive Voices During August Congressional Recess– Voice with Members, Staff– Leadership Voice in Our Communities
• Remember Who We Are– Mission Compels Us
© Ascension Health System Office Advocacy and Access Department, August 2009