Impact of Health Care Reform on Major Stakeholders February 25, 2010 Karen Ignagni America’s Health Insurance Plans

What Our Community Did to Prepare for 2009  Pivotal Board of Directors’ Decision  Proposal in November, 2006 to Get All Americans Covered  Proposal in March, 2007 to Improve Quality  Proposal in December, 2007 to Guarantee Coverage in Individual Market  Proposal in May, 2008 to Contain Costs  Summer “Listening Tour”  Proposal in November, 2008 for Individual Market Reform  Proposal in December, 2008 for Comprehensive Reform

What Did We Propose Before the 2009 Debate Began and Why?  Guaranteed Issue  No Pre-existing Conditions Limitations  No Health Status Rating  No Gender Rating  Everyone Insured and Participating in the Risk Pool  Strengthening of the Safety Net  Help for Small Businesses  Subsidies for Working Families  Cost Containment

Contributions During 2009 – In Addition to Market Reforms  Worked with Other Stakeholders on Effort to Create a National Commitment to Reducing Future Rate of Growth  Committed to Aggressive Requirements to Address Administrative Simplification  Committed to “Stabilization Fund” to Smooth Out Transition Costs for Individuals  Committed to Support Medicare Advantage Being Part of the Health Care Solution While Preserving Access Across the Country

Why We Began to Develop Concerns  Erosion of Mandate  Significant Contraction of Rate Bands to a Level that Would Raise Costs Significantly for Young People.  Premium Tax Layered on Top of Stabilization Fund  Lack of Cost Containment in Legislation  IMAC Exempting Key Cost Drivers  Prospect of Medicare Cuts Exacerbating Cost Shifting  Missed Opportunities for Sustainable Payment Reform Throughout the System  MA Cuts that Would have Shut Down the Program in Certain Areas  Proposed Federal Premium Regulation that Doesn’t Address Cost Drivers

Ten Opportunities for Common Ground  Insurance Reforms  Improved Safety Net  Cost Containment  Subsidies for Working Families  Payment and Delivery System Reform  Malpractice Reforms  Encouraging Prevention and Early Intervention  Administrative Simplification  State Exchanges  State Compacts

How Do We Do It  Discuss Responsibility of all Stakeholder Groups  Discuss How Containing Costs Can Offset the Price Tag of Reform, Phase-in Coverage Requirements and Fund Necessary Subsidies  Discuss How to Jump Start Payment and Delivery System Reform