Click Here for Slide Title by KevenMealamu

VIEWS: 3 PAGES: 14

									Welcome to CheckPoint HR’s Educational Forum on
Health Care Reform in America - Overview of Proposals and Related Issues

Congressman Rush D. Holt – Honored guest
Patrick Carragher – V.P. Benefits, CheckPoint HR
Rachel Smith – Corporate Communications, Martin Financial Group




                                                                           PAY R O LL




                                                                              HRMS




                                                                           BENEFITS
   Key Points
    • Legislative Process
    • Comparison of the Leading Proposals
    • Funding
    • Existing Plans – “Keep If You’re Happy”
    • Public Option
    • Summary




The Point of Difference in Human Resources
   Overview of the Proposals

          House Bill, H.R. 3200 (Dingell)

          Senate Health, Education, Labor and
           Pensions (HELP) Committee Bill (Kennedy)

          Future Consideration
             Senate Finance Committee Bill (Baucus)
             H.R. 676 – Single Payer Bill (Conyers/Kucinich)




The Point of Difference in Human Resources
                    Legislative Process
         House of Representatives                                      Senate




       7/14/09: Bill Introduced                         June/July 2009: Senate drafting separate version
              Bill Introduced                              Senate Introduces Bill –OR-
       7/15/09: Referred to Committee                         Sen. Baucus(Finance): in progress
              Committee
       7/17/09: Report from Congressional
                                                                     Consideration of House
                                                            SenateKennedy(Health): passed July 15
                                                              Sen.
       BudgetAssignment and the staff of the
               Office (CBO)                                 Bill
                                                        Future: Finance Committee Reviews and Markups
              Hearing Session
       Joint Committee on Taxation                         Committee Assignments
              Markup Session
       ONGOING: Revisions from Committees                  Hearing Session
             Committee Vote
            Energy & Commerce (Waxman)                     Markup Session
            Ways & Means (Rangel)
                                                           Committee Vote
            Education & Labor (Miller, Andrews, Holt)
                      HOUSE VOTE                          SENATE VOTE

                                             FINAL BILL

                               PRESIDENT SIGNS INTO LAW
The Point of Difference in Human Resources
                       Leading Bills - Comparison
                                       House Bill                  Senate HELP Bill

      Sponsors         Dingell                             Kennedy

      Proposed         94% of Population                   97% of Population
      Coverage

      Pooling          Health Insurance Exchange:          Health Benefit Gateway:
      Mechanism        -Individuals and Small Businesses   Voluntary Participation
                       -Larger Business Later?

      Government       Public Option                       Community Health Insurance Plan
      Plan

      Cost             Cost: $1.5 Trillion (10-Years)      Cost: $615 Billion (10-Years)

      Proposed         •Income Taxes on Wealthy            •Details Provided by Senate
      Funding          •Businesses Tax Increases            Finance Committee
                       •Cuts to Medicare/Medicaid
                       •Penalties – Indiv./Businesses




The Point of Difference in Human Resources
                  Senate Finance Committee
            Proposed Savings and Revenue Options

               Tax Implications
                 Tax Employer and Government Contributions to Health Care
                 Taxes on Lifestyle Items (Soda, Juice, Beer, etc.)
                 Reduce/Discontinue Medical Exp Deductions on Returns

               CDHP Changes
                 HSA: Limit Contribution to Deductible Amount
                 Increase Penalty on Non-Qualified Disbursements
                 HRA, FSA: Tax Part/All Contributions
                 No Reimbursement for OTC Drugs

               Medicare/Medicaid
                 Increase Rebates From Drug Companies
                 Impose Cost-Sharing on Medicare Supplemental Plans
                 Base Medicare Premiums on Income (mainly Part D)
                 Review/Adjust Charity Care Funds/Provider Rates


The Point of Difference in Human Resources
                                        Leading Bills - Comparison
                                                 House Bill                  Senate HELP Bill

          Individual Mandate                     2.5% Penalty                $750 Penalty

          Employer Pay or Play                   8% of Annual Payroll*       $750 (FT), $375 (PT)
                                                 72.5% Premium – single      60% Premium
                                                 65% Premium – family

          EXEMPT Employers                       <$250K ($500K) Payroll      25 or Less Employees
                                                 Tax Credits Available       Tax Credits Available
          Premium Subsidies                      Sliding Scale               Sliding Scale

          Essential Benefits Package             •No Cost Preventative       •No Cost Preventative
                                                 •Dental/Vision (Children)   •Coverage Until Age 26
                                                 •No Caps (Annual/Life)      •No Caps (Annual/Life)
                                                 •No Pre-Ex Cond. Excl.      •No Pre-Ex Cond. Excl.
                                                 •Guaranteed Coverage        •Guaranteed Coverage


          Medicaid Expansion                     Incomes Up To 150% FPL      Incomes Up To 133% FPL



          *Sliding Scale for Smaller Employers

The Point of Difference in Human Resources
          House Amendments - Examples
          Small Employer Benefit Arrangements (SEBA)
           1 Million+ Small Businesses Eligible (8.5 Million Workers)
           Small Businesses and Self-Employed:
               Share Resources
               Spread Risk
               Provide Collective Power in the Health Exchange
           Advantages:
               Lower Costs Due to Size/Efficiency
               Information, Expertise, Advocacy Services
          Source: http://hare.house.gov/uploads/SEBAs.pdf



           Unity Reform Package and Blue Dogs Amendments
            Reduce Subsidy Levels in Exchange (BD)
              Expand Small Business Exceptions from Pay or Play Requirement (BD)
              Simplify Medicare Admin Procedures, Put Savings to Low-Income Subsidies (U)
              Require All Exchange Plans to Get Approval for Higher Premium Increases
              Negotiate Part D Rx Prices
              Public Option Must Negotiate Provider Rates (Same as Private Plans)
              Public Option Must Use Drug Formulary (Cost Control)

           Source: House Energy and Commerce Committee Amendments




The Point of Difference in Human Resources
                                       Current Plans
                “Keep Your Plan If You’re Happy With It”

                     House Bill                            Senate HELP Bill

     No Enrollment Except Dependents           Enroll Dependents and New Employees

      No Change in Cost-Sharing               Does Not Have to Comply With New
      Premiums Can Increase                   Standards
      Conform to Standards:
             Guaranteed Issue/Renewal
             No Health Condition Exclusions
             No Annual/Lifetime Limits
             Rates Based on Only a Few
              Factors




The Point of Difference in Human Resources
           Public Plan - Comparisons
                                         House Bill                       Senate Bill
           Plan Types      Basic, Enhanced, Premium, Premium   At least Basic
                           Plus

           Premium         Based on Area                       Must Be Sufficient to Cover Costs


           Funding          $2 Billion Startup (90 Days        Startup Funds (90 Days
                             Claim Reserves)                     Claim Reserves)
                            10-Year Payback Schedule           10-Year Payback Schedule

           Providers        Medicare Rates                     Negotiated Rates
                            Incentives to Participate

           Enrollment      CBO Projects Only 3% of Americans
                           Will Enroll By 2019

           Other           Ombudsman, Benefits Administrator   Non-profit Entities to Administer




The Point of Difference in Human Resources
   CO-OPS: Public Option Alternative
   Sen. Kent Conrad (D-N.D.)

                 Consumer-Owned Nonprofit Cooperatives

               Competitor to Private Insurers

               Initial Government Funding: $3-4 Billion

               Operate Under National Structure With State
                Affiliates, Independent of Government

               Required to Maintain Financial Reserves

               Would Risk Pool Be Large Enough to Compete???




The Point of Difference in Human Resources
        Resources
        GOVERNMENT –
        White House Site: http://www.healthreform.gov/
        House Bill (Full Text): http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:
        House Energy and Commerce Committee: http://energycommerce.house.gov/
        House Education and Labor Committee: http://edworkforce.house.gov/
        House Ways and Means Committee: http://waysandmeans.house.gov/
        Senate HELP Bill (Full Text): http://help.senate.gov/BAI09A84_xml.pdf
        Senate HELP Committee: http://help.senate.gov/
        Senate Finance Committee: http://finance.senate.gov/
        Congressional Budget Office: http://www.cbo.gov/publications/collections/health.cfm

        RESEARCH -
        Kaiser Family Foundation: http://healthreform.kff.org/
        RAND: http://www.rand.org/research_areas/health/
        Health Reform Legislation Process:
        http://www.kaiseredu.org/tutorials/reformprocess/player.html

        OTHER –
        Examples of Impact of Health Care Measures:
        http://www.nytimes.com/interactive/2009/07/27/health/policy/20090728-health-table-
        graphic.html


The Point of Difference in Human Resources
   Summary

               Similarities to NJ Small Group Mandates

               Funding and Ultimate Affordability In Question

               Public Option – Will It Be Included?

               Revisions Still Forthcoming




The Point of Difference in Human Resources
                       Thank You.
            www.checkpointhr.com/webinarlibrary
Recording of Educational Forum and Materials will be available

								
To top