Katherine Hayes, JD

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Katherine Hayes, JD VP, Jennings Policy Strategies
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Health Reform 2009 Political Environment

• New Administration
• Congress - Larger Democratic Majorities
• Senate (51-49) Possible 4-6 seat pick-up
• House (235-199) Possible 25-30 seat pick-up

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Complicating Factors

• Economic Crisis Defining health care reform as
  critical to U.S. competitiveness and family
  economic security
• Deficit Projections - 400B in 2009 estimating
  before economic bailout. Historically Congress
  has addressed deficits with entitlement cuts
  (1997, 2005).
• Ghost of Health Reform Past

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Presidential Candidates on Health Reform

• Obama Builds on employer-based system and
  subsidies, addresses affordability through new
  group purchasing arrangement. Reforms insurance
  rules to bring high-risk individuals into group
  market.
• McCain Moves away from employer-based coverage
  uses tax credits to expand individual insurance
  market. Addresses high-risk individuals through
  state-based high-risk pools.
• Both candidates Promote prevention, improving
  quality and chronic care management.

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Health Reform Major Themes

• Cost Health insurance costs increasingly
  unaffordable for businesses, families, government
• Quality Not getting value for what we are
  spending
• Coverage Increasing number of uninsured, access
  issues

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House Health Committees

• Education and Labor Chairman, George Miller
  (CA)
• ERISA
• Workforce
• HIPAA
• Energy and Commerce Chairman John Dingell (MI)
• Medicare Parts B, C and D
• Medicaid
• Public Health Service Act and Workforce
• HIPAA
• Ways and Means - Chairman Charlie Rangel (NY)
• Medicare Parts A, B, C and D
• Internal Revenue Code
• HIPAA

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House Activity

• Ongoing Staff Discussions
• Hearings
• Prior Legislation
• Comparative Effectiveness Research
• Health Information Technology
• Medicare Physician Payment Reform

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Senate Health Committees

• Finance Chairman, Max Baucus (MT)
• Medicare
• Medicaid
• Internal Revenue Code
• HIPAA
• Health, Education, Labor and Pensions Chairman
  Ted Kennedy (MA)
• ERISA
• Public Health Service Act and Workforce
• HIPAA

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Senate Activity

• Senate HELP Committee
• Hearings, Stakeholder Meetings
• Chairman Kennedy - Legislation First 100 Days
• Senate Finance Committee
• Hearings
• Chairman Baucus White Paper in November
• Possible Bipartisan Legislation

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Framing Medical Homes in Health Reform

• Key to Delivery System Reform
• Cost Demonstrated long-term savings for
  highest-cost populations (where the spending is)
• Quality Improves patient outcomes
• Coverage Increases access to primary care,
  prevention services and care coordination
• Critical Component of Physician Payment Reform
  and Deficit Reduction

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Key Policy Makers

• Congress
• Committees of Jurisdiction and Leadership
• Congressional Budget Office (CBO)
• Health Information Technology
• Comparative Effectiveness
• Presidential Transition Teams
• Medicare Payment Advisory Commission (MedPAC)

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What Do Policy Makers Need?

• Specific Policy Recommendations with Data
• Medicare reimbursement changes (SGR) or new
  payment methodology
• GME reform
• Benefit design (covered benefits and
  cost-sharing)
• Accountability - If you want an investment of
  resources how will you measure success?