NAHU Legislative Update - PowerPoint PPT Presentation

1 / 20

About This Presentation

Title:

NAHU Legislative Update

Description:

NAHU Legislative Update – PowerPoint PPT presentation

Number of Views:75

Avg rating:3.0/5.0

Slides: 21

Provided by: davidl3

Category:

more less

Transcript and Presenter's Notes

Title: NAHU Legislative Update

1
NAHU Legislative Update

Kenneth L. Schmidt, CLU, RHU, REBC
NAHU Legislative Chair

2
State Childrens Health Insurance Program (SCHIP)
Reauthorization

NAHUs current top federal legislative priority
is the SCHIP reauthorization, with our focus on
increasing access to private premium assistance
programs.
Based on the current political climate, we know
that SCHIP will be reauthorized in some way and
that funding for the program will likely be
expanded.
Funding for SCHIP will expire on September 30th
if it is not reauthorized.

3
State Childrens Health Insurance Program (SCHIP)
Reauthorization

Just before the August recess, both the House and
the Senate passed very different versions of
SCHIP reauthorization legislation.
NAHU is OPPOSED to the House Bill, H.R. 3162.
The measure significantly expands the scope of
SCHIP, including providing coverage to
individuals up to age 25. It does nothing to
eliminate crowd-out and does not include any of
NAHU's recommendations to improve premium
assistance for eligible children who have access
to private employer-sponsored coverage.
Most disturbingly, the bill would effectively
eliminate the Medicare Advantage program, which
provides affordable private coverage to millions
of Seniors, in order to pay for a portion of the
proposed SCHIP expansion.

4
State Childrens Health Insurance Program (SCHIP)
Reauthorization

The Senate-passed legislation, H.R. 976, is
SUPPORTED by NAHU.
This measure also expands program funding, but
would do in a more limited way and solely through
an increase in the federal tobacco excise tax.
The Senate bill also includes the majority of
NAHU's recommendations regarding improving
premium assistance and would help reduce
crowd-out by phasing out SCHIP coverage of
childless adults.
President Bush has expressed his displeasure and
intention to veto both the Senate bipartisan
measure and the House bill, which passed on
essentially party lines.
President Bush is advocating a 5 billion package
that includes his individual tax credit at the
expense of the employer-sponsored health
insurance tax exclusion.
The Senate bill passed with a veto proof margin
of 68-31. However, bipartisan supporters have
indicated that the veto-proof support is
predicated upon the bill staying true to the
Senate-passed provisions and funding mechanism in
a conference committee.

5
State Childrens Health Insurance Program (SCHIP)
Reauthorization

Before the House Democrats announced their
intention to fund SCHIP in part by cutting the
Medicate Advantage program, NAHU attempted to
avoid the funding debate and instead concentrated
all of our efforts on premium assistance.
However, the association strongly supports the MA
program and does not want to see it cut.
We will not support any SCHIP reauthorization
bill that funds SCHIP by eliminating MA.
Also, while we favor individual market tax equity
for the purchase of health insurance, we do not
favor such a tax credit at the expense of the
existing employer exclusion.

6
State Childrens Health Insurance Program (SCHIP)
Reauthorization

It is likely that Congress and the President will
be unable to come to an agreement prior to the
expiration of the SCHIP funding. If so, Congress
will likely adopt a short-term current-level
funding fix (through the end of 2007).
There is also a possibility that if an agreement
is still not reached by the end of the year,
Congress will have to extend the program
temporarily for 1-2 years.
In that case, NAHU will lobby to have our premium
assistance provisions, which have broad
bipartisan support, included in the temporary
funding measure.
However, we would like to have this issue
resolved in a bipartisan fashion now, so that we
do not need to revisit the matter in two years in
a possibly much less friendly political climate.

7
Medicare Advantage

What is behind the House Democrats attack on
Medicare Advantage?
There has been recent negative publicity about
unethical producer behavior regarding the
marketing of Medicare Advantage fee-for-service
products
The result was three recent Congressional
hearings on the future of MA and sales practices
relative to Medicare-related product sales.
Small percentage of complaints, but cuts to MA
are seen by some as a valid pay-for for other
Democratic congressional health initiatives, like
SCHIP expansion.
State insurance commissioners advocating for
increased regulatory control over MA. They would
like it to mirror Medigap.

8
Medicare Advantage

What NAHU is doing on Medicare Advantage
Opposing the House SCHIP Bill that would fund
reauthorization by cutting MA.
Presented testimony at all three Congressional
hearings. NAHU Medicare Advisory Group member,
Peggy Olson, was invited to appear before the
House Energy and Commerce Oversight and
Investigations subcommittee to discuss the issue
from an agents perspective.
Direct federal lobbying and coalition work in
support of MA.
Senate Finance Committee staff briefing on the
role of the agent in Medicare-related product
sales.
Coordination with both the NAIC and CMS
NAHU/AHIP Medicare ethics training
Will testify at NAIC public hearing scheduled for
this fall.
NAHU upcoming radio campaign of value of an agent
The role of the agent issue critical because it
doesnt just apply to MA. There are a number of
large-scale federal reform proposals on the
table, and agents arent a part of most proposed
delivery systemseven ones that utilize other
aspects of the private market.

9
Other Federal Legislative Actions

Trade Adjustment Assistance Act
Must be reauthorized in 2007
Trying to make it easier for states with
purchasing options
Possible expansion to other populations
NAHU has submitted testimony for two related
Congressional Committee hearings
Will be come a bigger focus for Congress and NAHU
after SCHIP is resolved.
High-Risk Pools
Continuing efforts to restore federal funding
Monitoring large-scale congressional legislative
proposals, presidential campaign proposals and
single-payer discussions

10
Leading Congressional Health Reform Proposals

Senator WydenDismantles existing employer-based
system, state pooling arrangements, community
rating and guarantee issue, no role for agents
and brokers
Senator Kennedy/Representative DingellMedicare
for All
Representative StarkAmeriCare
Senator Bingaman/Representative Baldwin--Grants
to states to carry out any of a broad range of
strategies to increase health care coverage
Senator EnziIndividual mandate, guarantee issue
and tight rating requirements on all products,
pooling of individual and group markets, required
community rated and price-controlled products
from each carrier, small business health plans,
and standard deduction to pay for individual or
employer coverage.
Senator HarkinAllows employers a 50 tax credit
for the costs of providing employees with a
qualified wellness program

11
Presidential Campaign 2008

Health care will be the top domestic policy issue
during this extended campaign cycle.
Many candidates favor comprehensive reform that
could dismantle the private market and leave no
room for producers.
Single payer, national exchanges, shift away from
the employer-based system all under serious
debate.
NAHUs analysis of presidential health care
reform proposals is updated regularly and
available online.

12
NAHU Single Payer Project

Comprehensive toolbox for NAHU members and
chapters to provide a response to single-payer
advocates
PowerPoint presentation with detailed speakers
notes and delivery training video
Handouts including summary and resource list
CE outline
Ready-made press materials
Development committee is currently working on
even more tools for members, including
Reduced length presentations for different
audiences
Adding additional up-to-date information and
statistics about other countries
Sound bite information, additional handouts and
more media materials
Presentation about NAHUs private-market
solutions

13
What is NAHUs Solution?

Healthy AccessAffordable and Responsible
Healthcare Reform
NAHUs comprehensive plan for health care reform
Also a yardstick for evaluating other broad
proposals
Adopted by NAHUs Board of Trustees June 2007
Focuses on containing health care costs and
ensuring access for all Americans
Recommendations paper and three supporting
briefing reports
Adaptable for state legislative purposes

14
Healthy Access

Healthy AccessNAHUs Vision for Affordable and
Responsible Health Reform contains three
components
Cost Containment
Health Insurance Access for All
Financing Access

15
Healthy AccessCost Containment

Affordability is the biggest health insurance
access issue for Americans, and the reason health
insurance is expensive is skyrocketing medical
care costs.
To reduce the costs of medical care and health
insurance, NAHU proposes
Wellness and disease management program
incentives to increase healthy behaviors,
including mandatory participation by all state
and federal health programs (i.e, Medicare,
Medicaid, SCHIP, VA).
Elimination of cost-shifting by requiring federal
reimbursement of Medicare and Medicaid providers
at the same level as the FEHBP.
Increased price transparency and improvements to
CDHC.
Commonsense medical malpractice reforms

16
Healthy AccessAccess For All

In addition to reducing costs and improving
affordability, we have to make sure that private
market health insurance is available to all
Americans who want to purchase it.
To ensure access for all we propose
Guaranteed individual market purchasing option,
with incentives for high-risk pools
Federal grants to states that adopt
market-friendly reforms and premium subsidy
programs
Congressional study of reinsurance programs
Tax law changes to create equity for individual
market health insurance purchasers while still
preserving the current employer-sponsored
coverage federal tax exclusion, as well as
changes that facilitate the sales of list-billed
individual health insurance products in an
employer setting if done through licensed
producers.
A NAHU education certification program to ensure
that health insurance producers are informed
about state and federal health coverage programs
and can educate clients about them and assist
individuals with enrollment according to need and
eligibility.

17
Healthy AccessFinancing Access

Many of the initiatives proposed in the first two
components of healthy access will actually reduce
public and private health care expenditures.
However, parts of healthy access such as the
elimination of cost-shifting and grants to states
to encourage reforms and subsidies, will require
financing.
To fund NAHUs healthy access reforms, we support
taxes or assessments on goods and services that
contribute to unhealthy behaviors such as smoking
and obesity, such as
Cigarettes and other tobacco products
Unhealthy food products and fast food restaurant
meals
Alcoholic beverages
Handguns and their ammunition