Welcome to CheckPoint HRs Educational Forum on Health Care Reform in America Overview of Proposals a

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Welcome to CheckPoint HRs 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
P A Y R O L L
H R M S
B E N E F I T S
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Key Points

• Legislative Process
• Comparison of the Leading Proposals
• Funding
• Existing Plans Keep If Youre Happy
• Public Option
• Summary

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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)

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Legislative Process

• Senate

• House of Representatives

7/14/09 Bill Introduced 7/15/09 Referred to
Committee 7/17/09 Report from Congressional
Budget Office (CBO) and the staff of the Joint
Committee on Taxation ONGOING Revisions from
Committees Energy Commerce (Waxman) Ways
Means (Rangel) Education Labor (Miller,
Andrews, Holt)

• June/July 2009 Senate drafting separate version
• Sen. Baucus(Finance) in progress
• Sen. Kennedy(Health) passed July 15
• Future Finance Committee Reviews and Markups

• Senate Introduces Bill OR- Senate Consideration
  of House Bill
• Committee Assignments
• Hearing Session
• Markup Session
• Committee Vote

• Bill Introduced
• Committee Assignment
• Hearing Session
• Markup Session
• Committee Vote

HOUSE VOTE
SENATE VOTE
FINAL BILL
PRESIDENT SIGNS INTO LAW
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Leading Bills - Comparison
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Senate Finance CommitteeProposed 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

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Leading Bills - Comparison
Sliding Scale for Smaller Employers
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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

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Current PlansKeep Your Plan If Youre Happy
With It
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Public Plan - Comparisons
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CO-OPS Public Option AlternativeSen. 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???

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Resources
GOVERNMENT White House Site
http//www.healthreform.gov/ House Bill (Full
Text) http//thomas.loc.gov/cgi-bin/query/z?c11
1H.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/p
layer.html OTHER Examples of Impact of Health
Care Measures http//www.nytimes.com/interactive/
2009/07/27/health/policy/20090728-health-table-gra
phic.html
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Summary

• Similarities to NJ Small Group Mandates
• Funding and Ultimate Affordability In Question
• Public Option Will It Be Included?
• Revisions Still Forthcoming

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Thank You.www.checkpointhr.com/webinarlibraryRec
ording of Educational Forum and Materials will be
available