The Evolving Health Policy Landscape: What’s in Store for 2018

Winnetka Rotary

November 16, 2018

Peter W. Butler

Professor and Chairman, Department of Health Systems Management

Rush University

Health Care Back in the Forefront

New End-Arounds Pushing for Greater Health Care Coverage

“Maine just resoundingly became the first state to expand Medicaid by ballot initiative”

Washington Post November 8, 2017

Tax Reform (Maybe), Then Along Comes a December 8 Government Shutdown?Potential issues on the December 8 government funding bill:

• Spending caps• CHIP reauthorization (9 million kids with coverage)• Obamacare CSR subsidies to stabilize marketplaces• DACA (Dreamers)• Funding for the border wall• Hurricane relief

Best bet may be another stop gap funding bill to punt issues to January

Government Versus Private Market

Democrats

Current State

Republicans

Employer-Based

155 million

Individual (exchanges)18 million

BernieSanders

Rand Paul

GovernmentRun

Private Market

Medicaid74 million

Medicare55 million

How Many People Should Have Coverage? CBO Weighs In and Changes the Trajectory

Most Want Bi-Partisan Effort

Public Opinion Moving to the Left

Where You Live Matters

There is up to a 16-year gap in life expectancy between

the Loop and West Side neighborhoods

Bi-Partisan Support for Addressing Drug Pricing

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Current Balance of Power in Congress

U. S. Senate52 Republican46 Democrat

2 Independent

U. S. House of Representatives240 Republican194 Democrat

1 Vacant

Paul Ryan (R-WI)

Speaker of the House

Mike Pence (R-IN)

U.S. Vice PresidentSenate President

Mitch McConnell (R-KY)

Majority Leader

Chuck Schumer (D-NY)

Minority Leader

Kevin McCarthy (R-CA)

Majority Leader

Nancy Pelosi (D-CA)

Minority Leader

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Congressional Election Landscape 2018

15

Congressional Election Landscape 2018

House Races 2018

Source: Roll Call

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Illinois General Assembly

Illinois Senate

37D

22 R

Thirty-six votes are needed to override

a Governor’s veto in the Senate.

President Cullerton

67D

51R

Illinois House

Seventy-one votes are needed to override a

Governor’s veto in the House.

Speaker Madigan

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Illinois – Election Landscape 2018

Governor Bruce Rauner (R)incumbent

J. B. Pritzker (D)candidate

Chris Kennedy (D)candidate

$200 Million Governor’s Race???

Jay Robert Pritzker (age 52) is managing partner and co-founder of the Pritzker Group, a private investment firm , and president of the Pritzker Family Foundation, which funds innovative research and programs serving children in poverty. He is a member of the well known Pritzker family who own the Hyatt Hotel chain. JB’s estimated personal net worth is $3.4 billion. He graduated Duke University and Northwestern University School of Law. He is the father of two children with his wife of 24 years.Pritzker served as national co-chairman of the 2008 Hillary Clinton for President campaign and as a delegate to the 2008 & 2016 Democratic National Convention. He supported President Barack Obama in the 2008 general election and helped unite the Clinton and Obama campaigns in Illinois. In 1998, he finished third among five candidates in the Democratic primary in Illinois's 9th U.S. Congressional District.

Bruce Rauner (age 60) is the 42nd Governor of Illinois. Prior to his election, he was the Chairman of R8 Capital Partners and Chairman of the private equity firm GTCR. On November 4, 2014, Raunerwon the election, beating Democratic incumbent Pat Quin, with 50.27% of the vote. He carried every county except Cook. Rauner's net worth is estimated at several hundred million dollars. He accepts only $1 in salary and no benefits from his office. His philanthropic endeavors projects for the Red Cross , the YMCA, charter schools, and scholarship programs for disadvantaged public school students. He is a graduate of Dartmouth College and earned his MBA at Harvard University. He is the father of three children from his first marriage and three children with his wife, Diana, president of the non-profit Ounce of Prevention Fund.

Chris Kennedy (age 54) is Chair of Joseph P. Kennedy Enterprises, Inc. He is a son of former U.S. Senator Robert F. Kennedy. His personal net worth is unknown, but the estimated Kennedy family net worth is $1 billion. He served as Chair of the Board of Trustees for the University of Illinois from 2009 to 2015. Until April 2012, he was president of Merchandise Mart Properties, a commercial property management firm. In May 2012, Kennedy founded Top Box Foods, a Chicago-based hunger-relief non-profit. He has served on the Executive Committee for the Chicago Community Trust, and has been a board member of the Catholic Theological Union, Interface, Inc. and Knoll Inc. He has also served as Chairman of the Board of the Greater Chicago Food Depository, and is a member of the board of trustees for Ariel Investments. Kennedy graduated Boston College and earned his MBA at Northwestern University. He is the father of four children with his wife of 30 years.

The move from volume to valueThe move away from a fee-for-service is growing as insurance risk tied to per capita spending is being passed along from government to insurers and providers.

Over 30% of Medicare

Beneficiaries Are Enrolled in a

Medicare Advantage Health Plan

The Looming Impact of Baby Boomers

Too Few Workers To Support Social

Security and Medicare (Part A)

through FICA