Health Care Reform Federal Updates and Priorities Grace Campbell Regional Director, State Advocacy December 5, 2013

Important Dates SMTWTFS DecemberJanuary FebruaryMarch Final day for enrollment to count 1/1/14 SMTWTFS Coverage begins Budget Conference Committee Reports Congress must approve CR to keep government open SMTWTFS Federal government reaches debt ceiling SMTWTFS 1/ Day Announcement Open Enrollment Ends Last Day to select plan for April 1 Effective Date

Proposed Federal ACA Related Legislation Extend Open Enrollment Introduced by Senator Shaheen Potential Impact on 2015 Premiums 1 Year Mandate Delay Introduced by Senators Manchin & Kirk Breaking “The Link” will increase premiums Policy Cancellations Bills in House & Senate Changes rules in middle of the game; impacts 2015 premiums

Breaking the Link: States’ Experience Says It All Coverage Disruptions Higher Premiums No Reduction in Uninsured

Priority Issues Affordability Health Insurance Tax Public Programs Health Care Cost Roadmap

Priority Issue: Affordability “First Rule” of PremiumsNew Benefits = New Costs Changing rules could impact premiums

Priority Issue: Affordability – What Plans Are Doing Plans Meeting the Affordability Challenge Head On Constructing Plans to Balance Affordability and Quality Innovative Benefit Design

Priority Issue: Health Insurance Tax (HIT) A $100 Billion “Hidden” Tax on Premiums Makes Health Insurance More Expensive…Undermines Goals of Reform 2 Year Delay of HIT Provides Immediate Relief for Families, Employers & Seniors

Priority Issue: Medicare Advantage More than 14 Million Americans Enrolled Higher-Quality Care to Seniors Protections Against Out-of-Pocket Costs Overwhelming SatisfactionBut…

Priority Issue: Medicare Advantage ACA Cut $200 Billion (and New Health Insurance Tax) Impact on Beneficiaries = Higher Costs, Less Benefits, Loss of Choice Seniors Cannot Afford to Have Program Cut More

Priority Issues: What’s Driving Health Care Costs? Medical Liability Fee-for-Service Provider Consolidation Cost Shifting Demographics “Innovation” Bias Lifestyle Choices Cost Opacity

Priority Issues: Our Roadmap