2. Problem
Cost of Health Care – Rising – 18% of
Gross Domestic Product ($2.6 Trillion) –
Highest in the World – however, US ranks
50th in the world in life expectancy
50 million people are uninsured
1 in 6 Americans
Three pandemics contribute to preventable
chronic diseases – tobacco use, obesity &
lack of physical activity
Capitalism in Health Care – health care
driven by profit
3.
4. Federal Healthcare
Reform 2010
Overall Expected Outcomes
Reduction in Cost of Health Care
Keeping People Healthy and Preventing Illness
Treating the Sick and Keeping Costs Low
5. Federal Healthcare
Reform 2010
Strategies Include
Illness and Disease Prevention
Improving Access to Healthcare
Quality Care Incentives
Restructure Healthcare Delivery and Operations
Restructure Insurance Products
6. Federal Healthcare
Reform 2010
Illness and Disease Prevention
$5 billion from 2010 to 2014 in the Public Health Fund
to invest in increasing the number of health professionals
and to increase programs in smoking cessation,
weight loss, immunizations, etc.; $2 billion for each
subsequent fiscal year
Providing free preventive care, such as: mammograms
and colonoscopies for Seniors
Offering Seniors prescription drug discounts, such as:
50% discount for brand name and generic drugs
7. Federal Healthcare
Reform 2010
Improving Access to Healthcare
Options for States to cover more people on Medicaid starting in
2010. Federal matching funds for broadening coverage will be
available in 2014 when program is mandatory
Tax credits to employers with 25 employees or less & average
annual wages of < $50,000 that provide health insurance for
employees
Permanently authorizes the Federally Qualified Health Centers
(FQHC) and National Health Service Corps (NHSC) programs and
increases funding for FQHC and the NHSC from 2010 - 2015
Increasing access for Medicaid recipients for services at home and
in the community. This provision allows States to provide
disabled individuals care at home rather than in institutions
8. Federal Healthcare
Reform 2010
Quality Care Incentives
Reduced Medicaid payments to hospitals for hospital
acquired conditions, such as a hip fracture resulting
from a fall
Reduced Medicare payments to hospitals for
hospital acquired conditions, such as infections
Reduced Medicare payment to hospitals for excess
(preventable) readmissions
Medicare establishes a “value based purchasing”
program to pay hospitals based on Patient
outcomes and quality performance
9. Federal Healthcare
Reform 2010
Restructure Healthcare Delivery and Operations
Incentives for physicians to form Accountable Care
Organizations to coordinate patient care, prevent illness and
reduce admissions to hospitals to share in Medicare cost savings
Implementing electronic health records to reduce paperwork,
administrative burdens, and most importantly reduce medical
errors
Bundled payments to hospitals, physicians, and other providers to
align incentives, and to allow savings to be shared between
providers and the Medicare program
Reducing healthcare fraud and waste in Medicare and Medicaid
10. Federal Healthcare
Reform 2010
Restructure Insurance Products
Extends dependent coverage for adult children up to age 26 for all
individual and group policies 09/2010
Grants to States to plan for Health Insurance Exchanges for
purchase of insurance by individuals and small employers
States may create a basic health plan for uninsured individuals
with incomes between 133 – 200% FPL
Requires Federal Government to create a process in conjunction
with States, for insurers to justify unreasonable premium
increases. Grants provided to States for reviewing premium
increases
Requires U.S citizens and legal residents to have qualifying
health coverage 01/2014
11.
12. Mitt
Romney
Plans to have federal government issue
waivers to all fifty states from current
health care reform legislation
Restore State Leadership and Flexibility
Block grant Medicaid and other
payments to states
Limit federal standards and
requirements on both private insurance
and Medicaid coverage
13. Mitt
Romney
Ensure flexibility to help the uninsured,
including public-private partnerships,
exchanges, and subsidies
Ensure flexibility to help the chronically ill,
including high-risk pools, reinsurance, and
risk adjustment
Offer innovation grants to explore non-
litigation alternatives to dispute resolution
14. Mitt
Romney
Promote Free Markets and
Fair Competition
Cap non-economic damages in medical
malpractice lawsuits; provide innovation grants
to states for reforms such as alternative dispute
resolution or health care courts
Empower individuals and small businesses to
form purchasing pools
Prevent discrimination against individuals with
pre-existing conditions who maintain
continuous coverage for a period of time
Facilitate IT interoperability
15. Mitt
Romney
Empower Consumer Choice
End tax discrimination against the
individual purchase of insurance – reform
the tax code
Allow consumers to purchase insurance
across state lines without costly state
benefit requirements
Unshackle HSAs by allowing funds to be
used for insurance premiums
16. Mitt
Romney
Empower Consumer Choice
Promote "co-insurance" products
Promote alternatives to "fee for service“
Encourage "Consumer Reports"-type
ratings of alternative insurance plans
