- 1.ObamaCare: Taking it to the A not-for-profit health and tax
policyresearch organization Court of Public Opinion Grace-Marie
Turner October 16, 2012 Baltimore Association of Health
Underwriters /GalenInstitute www.galen.org
2. www.galen.org 3. www.galen.org 4. www.galen.org 5.
www.galen.org 6. Source: Ari Melber,POLL: Half of Americans Dont
Know How Court Ruled on Healthcare, The Nation, July 4,
2012,http://www.thenation.com/blog/168720/poll-half-americans-dont-know-how-court-ruled-healthcare#.
7. A not-for-profit health and tax policyresearch organization
/GalenInstitute www.galen.org 8. What supporters highlight: A
not-for-profit Free preventive care Allowing children up to age 26
health and tax policyresearch organizationon parents policies Pools
for pre-existing conditionpolicies $250 for seniors with high
drugcosts /GalenInstitute www.galen.org 9. Americans viewsof
Supreme Court decision Americans say the health law will make
thingsworse rather than better for taxpayers,businesses, doctors,
and those who currentlyhave health insurance. Health care will be
an extremely or veryimportant issue for 82% of Americans indeciding
their vote for the president inNovember. Opposition to the law is
higher now thanbefore the Supreme Court decision.Sources:
Americans: Healthcare Law Helps Some, Hurts Others , Gallup, July
16, 2012,
http://www.gallup.com/poll/155726/Americans-Healthcare-Law-Helps-Hurts-Others.aspx?utm_source=add%2Bthis&utm_medium=addthis.com&utm_campaign=sharing#.UARkmBS6osE.twitter.
The New York Times/CBSNews Poll, July 11-16, 2012,
http://s3.documentcloud.org/documents/402362/jul12a-ocr.pdf. Kaiser
Health Tracking Poll, The Kaiser Family Foundation, July2012,
http://www.kff.org/kaiserpolls/upload/8339-C.pdf 10. Source: Kaiser
Family Foundation, July 2012. 11. What ObamaCare really does
Expands taxpayer subsidies to +/- 30 million people Citizens
required to purchase approved health insurance or face new taxes
Most employers required to offer coverageSignificant new federal
regulation of the health sector with 159 new federal regulatory
agencies and programsMedicaid may or may not be expanded by
statesCuts in Medicare spending; IPAB rationing boardFinanced by
$741 billion in cuts to Medicare $569 billion in new taxes and
penaltiesReal cost: $2.6 trillion over 10 yearsSource: Letter to
the Honorable John Boehner providing an estimate for H.R. 6079, the
Repeal of Obamacare Act, Congressional Budget Office, July24, 2012,
http://cbo.gov/publication/43471. 12. Two issues:Taxes. Trust. 13.
Source: Alison Meyer, Chart of the Week: Obamacares 17 New Taxes,
The Heritage Foundation, March 25,
2012,ttp://blog.heritage.org/2012/03/25/chart-of-the-week-obamacares-17-new-taxes/.
14. ObamaCares New TaxesSource: Philip Dittmer and William McBride,
Obamacares New Taxes, And How You May Be Affected, Tax Foundation,
July 5,
2012,http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
15. More ObamaCare TaxesSource: Philip Dittmer and William McBride,
Obamacares New Taxes, And How You May Be Affected, Tax Foundation,
July 5,
2012,http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
16. Do you think the health care reform plan thatCongress passed
recently will increase, decrease, or have no effect on each of the
following: Taxes Federal Deficit Health Care Costs Insurance
Premiums Health Care QualitySource: AM&A, Resurgent Republic
1st Anniversary Survey of Likely Voters, April 25-27, 2010 17.
Trust: Costs wont fall by$2,500/familyCBO:The law will raise some
familypremiums by $2,100 in 2016 abovewhat they would have been
withoutthe reform lawHealth insurance already hasincreased by
$1,700 for the averagefamily since 2009 to $15,073 in 2011Richard
S. Foster, Chief Actuary, Estimated Financial Effects of the
Patient Protection and Affordable Care Act, as Amended, U.S.
Department of Health and HumanServices, Centers for Medicare &
Medicaid Services, Office of the Actuary, April 22, 2010,
www.cms.gov/ActuarialStudies/Downloads/PPACA_2010-04-22.pdf.Congressional
Budget Office and the Joint Committee on Taxation, An Analysis of
Health Insurance Premiums Under the Patient Protection and
Affordable Care Act,November 30, 2009,
www.cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf.Employer
Health Benefits 2011 Annual Survey, The Kaiser Family Foundation
and Health Research & Educational Trust, September27, 2011,
http://ehbs.kff.org/pdf/2011/8225.pdf.www.galen.org 18. TRUST: If
you like your health insurance 51 to 80% of Americans will lose
current coverage,according to Obama admin. estimates CBO: Up to 20
million could lose job-based plans McKinsey: Up to 80 million will
be forced to changepolicies Child-only policies will vanish in 17
states 35 million more will move from job-based insurance
totaxpayer-subsidized exchangesFact Sheet: Keeping the Health Plan
You Have: The Affordable Care Act and Grandfathered Health Plans,
U.S. Department of Health and Human Services,
HealthReform.gov,http://www.healthreform.gov/newsroom/keeping_the_health_plan_you_have.html."CBO
and JCTs Estimates of the Effects of the Affordable Care Act on the
Number of People Obtaining Employment-Based Health Insurance,"
Congressional Budget Office, March
2012,http://www.cbo.gov/publication/43082.Shubham Singhal, Jeris
Stueland, and Drew Ungerman, How US health care reform will affect
employee benefits, McKinsey Quarterly, June
2011,www.mckinseyquarterly.com/Health_Care/Strategy_Analysis/How_US_health_care_reform_will_affect_employee_benefits_2813.Health
Care Reform Laws Impact on Child-Only Health Insurance Policies,
Senate Committee on Health, Education, Labor and Pensions, August
2,
2011,http://www.help.senate.gov/imo/media/doc/Child-Only%20Health%20Insurance%20Report%20Aug%202,%202011.pdf.Douglas
Holtz-Eakin and Cameron Smith "Labor Markets and Health Care
Reform: New Results," American Action Forum, May 27,
2010,http://americanactionforum.org/sites/default/files/OHC_LabMktsHCR.pdf.www.galen.org
19. Source: Frank Hill, The High Cost Impact of More Regulation and
Admin/Executive Staff on Health Care Inflation, Telemachus, July
22,
2012,http://www.telemachusleaps.com/2012/07/the-high-cost-impact-of-more-regulation.html.
20. Studies on employers plans Deloitte: 1 in 10 plan to drop
coverage; 1/3 considering it Mercer: 60% expect higher costs Up to
46% plan changes to avoid penalties 56% were waiting until after
SCOTUS to plan; 11% will wait until after November National
Business Group on Health Health costs expected to rise by 7% next
year 60% expect to increase employees premium shareSources: 2012
Deloitte Survey of U.S. Employers: Opinions about the U.S. Health
Care system and Plans for Employee Health Benefits, Deloitte Center
for Health Solutions &Deloitte Consulting, July 2012,
http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/us_dchs_employee_survey_072512.pdf;
Large Employers 2013Health Plan Design Survey, National Business
Group on Health, August 2012,
http://www.businessgrouphealth.org/pressrelease.cfm?ID=201; Health
Reform Poses BiggestChallenges to Companies with the Most Part-Time
and Low-Paid Employees, Mercer LLC, August 8, 2012,
http://www.mercer.com/press-releases/1472805. 21. NBGH Large
employer surveySource: Large Employers 2013 Health Plan Design
Survey, National Business Group on Health, August
2012,http://www.businessgrouphealth.org/pressrelease.cfm?ID=201.
22. New Mercer study on employer plansw Mercer study on what
employers expectSource: Health Reform Poses Biggest Challenges to
Companies with the Most Part-Time and Low-Paid Employees, Mercer
LLC, August8, 2012, http://www.mercer.com/press-releases/1472805.
23. Generous Subsidies in ExchangesExamples: A person earning
$42,000 a year with a familyof 4 qualifies for $14,759 in new
healthinsurance subsidies A single person earning $20,600 qualifies
for$5,156 in new health insurance subsidiesBut only if employer
doesnt offer coverage orif its not affordable (costs >9.5% of
income)www.galen.org 24. Employer mandate penaltiesFor companies
with +50 employees $2,000 per year per employee for notproviding
coverage (minus first 30) $3,000 per year for any employee
gettinginsurance through the Exchanges* If an employer offers
employee-onlycoverage thats affordable to the worker,family members
are not eligible for Exchangesubsidieswww.galen.org 25. An
onslaught of bureaucracy Exchange regs issued March 12;final rules
after the election States to decide content ofEssential Health
Benefit packages Cato believes legislators can protectagainst
employer mandate penaltiesby not setting up exchanges. 26. State
Action (or not) Re: ExchangesSource: State Action Toward Creating
Health Insurance Exchanges, as of August 1, 2012, The Henry J.
Kaiser FamilyFoundation,
http://www.statehealthfacts.org/comparemapdetail.jsp?ind=962&cat=17&sub=205&yr=1&typ=5.
27. Health care in 2012 Legislation Depends upon the outcome of the
election Regulation 13,000+ pages so far Legal Many other court
challenges continue Political The voters will ultimately decide on
Nov. 6www.galen.org 28. Some realitieswww.galen.org 29. Widespread
pushback Economic nightmare A not-for-profit health and tax policy
Killing jobs and suffocating economic recoveryresearch organization
46% of doctors plan to leave practice Impossible complexity
Multiple deadlines missed by Obama bureaucrats Enormous costs,
complexity, privacy issues 13,000 pages of regulations -- so far
Resistance from states Balking at setting up exchanges or otherwise
complying Weighing Medicaid expansion /GalenInstitute www.galen.org
30. Americans agreed on goals for health reform The U.S. needs
health reform to: make coverage more affordable assure quality, and
expand access to insurance Most people rate their own coverage as
good or excellent They want stability. Change is for
others.www.galen.org 31. Growth of HSA-Qualified High-Deductible
Health PlanEnrollment, Covered Lives (Millions),March 2005 to
January 2012 Note: Companies reported enrollment in the large- and
small-group markets according to their internal reporting
standards, or by state-specific requirements for each state. The
Other Group category contains enrollment for companies that could
not break down their group membership into large- and small-group
categories within the deadline for reporting. The Other category
was necessary to accommodate companies that were able to provide
information on the total number of people covered by HSA/HDHP
policies, but were not able to provide a breakdown by market
category within the deadline for reportingSource: AHIP Center for
Policy and Research (May 2012). 32. Even Europeans going the other
way Consumerism Value of private enterpriseand competition
Doctor-patient relationship
Decentralizeddecision-makingwww.galen.org 33. Why ObamaCare Is
Wrong for AmericaHow does the health care lawdrive up costs?Is your
doctor really in charge ofyour health care decisions?Are your
Constitutional rightsthreatened?Discover the laws impact onyour
life in a new book fromfour nationally recognizedhealth policy
expertsPublished by Broadside Books,an imprint of
HarperCollinswww.WrongForAmericaBook.comwww.galen.org 34.
Grace-Marie Turner A not-for-profit health and tax policyresearch
organization Galen Institute 703-299-8900 [email protected]
twitter.com/GalenInstitute facebook.com/GalenInstitute Subscribe to
our free email alerts at /GalenInstitute www.galen.org
www.galen.org/subscribe 35. Studies show law fails to meet goals
Health costs and health spending increase One-third of businesses
may drop insurance Young people worried about high cost ofpolicies
Doctors concerned about Medicaidexpansion and fraying the safety
net Seniors worried about rationing of care andfinding a doctor who
takes Medicare 30 million will remain uninsured -- CBOwww.galen.org
36. EmployerOptions Fully insured group plan Self-funded group plan
Defined Contribution/PRA Offer nothing 37. Fully insured group
plansFamiliar easier to stay Rising costs with what you know
Participation requirements Tax credit maybe doubt it Funding
requirementsRisk pooling Minimum benefitMay qualify for small
grouprequirements tax credit 38. Self-funded group plans Stop loss
and TPAs becoming < 9.5% of AGI still appliesmore competitive
(as few as 10 ees) More vulnerable to costs of Lower costs and
attachment catastrophic illness from pointsjust one or two
employees Exempt from most state and some ACA regulations Greater
design flexibility 39. Defined Contribution/Premium Reimbursement
PlansMore ER control over costs May still have to payMore
affordable options for penaltyemployees Short learning curve
whenMany employees that makedoing anything differentless than 400%
FPL will befrom what you are used to better off
