OBAMACARE 101 W H AT YO U N E E D TO K N OW M AY 2 0 1 3 E N E - - PowerPoint PPT Presentation

W H AT YO U N E E D TO K N OW M AY 2 0 1 3 E N E RG Y & CO M M E RC E CO M M I T T E E WAYS & M E A N S CO M M I T T E E

OBAMACARE 101

How Did We Get Here?

 2,801 Page Bill After Contentious 2-year Partisan

Debate

 “Secret Deals” Between White House And Industry

Groups To Support Passage

 Bill Passed In 2010 By Democrat House And Senate

With Only Democratic Votes And Signed Into Law By President Obama On March 23, 2010

2

3

So, What’s in it?

 Completely Restructures the Health Care

Industry – One-Fifth of the US Economy

 Federal Mandates – All Must Have Insurance:

 Beginning January 1, 2014, unless granted an exemption, all

Americans must either purchase government-approved insurance or pay a tax to the IRS.

 Employers with 50 or more full-time employees must offer

affordable insurance to employees and their dependents or pay

• ne of two different penalties.

 $1.1 Trillion In New Taxes; Including Taxes On

Medical Devices, Drugs, Insurance Premiums, “Cadillac” Plans, Unearned Income

4

So, What’s in it?

 Costly, Expanded Government Programs

 Medicaid Expanded Starting In 2014  Insurance Offered Through Exchanges For Some Starting In 2014  Open enrollment starts on October 1, 2013 – in 139 days  All Americans must complete a burdensome application form to

enter an Insurance Exchange

 $716 Billion In Cuts To Medicare Providers And Plans

5

2014: “State” Exchanges

 Insurance “Marketplace” For Individuals And Small Business  HHS Administers Exchanges In Lieu Of States; Some States

Entering Into “Partnership” To Share Responsibility

 “State” In Name Only: ACA Requirements And Federal

Regulations Drive What Can Be Offered In State, Partnership And Federal Exchanges

 Much Of 20k Pages Of Regulations Issued So Far Relate To

Exchange/Insurance Regulation

 Benefit Design, Cost-sharing, And Even Participating Doctors

And Providers Subject To Federal Control And Oversight

 $1 Trillion For Sliding Scale Premium/Cost-sharing Subsidies

For Individuals/Families Up To 400% Of Federal Poverty

6

State Decisions For Creating Health Insurance Exchanges

As Of May 2, 2013

7

http: Kaiser Family Foundation, statehealthfacts.org

18 7 26

2014: Medicaid Expansion

 Originally - Mandated Nationwide Expansion  After Supreme Court Decision- States Have Option To Expand Up To 138

% Of The Federal Poverty Level (FPL) (Approximately $15,860/Year For Household Of 1)

 As Many As 26 Million NEW Enrollees (Mostly Able-bodied, Childless

Adults)

 1 In 4 Americans Could Be On Medicaid Within 10 Years – Beyond

Original Intent

 Feds Will Spend: $638 Billion On Expansion ($5 Trillion In Total

Federal Medicaid Spending)

 States Will Spend: An Additional $2.5 Trillion Over Same Time Period,

As Much As $118 Billion On Expansion – taking away from other taxpayer priorities (i.e. education, public safety, tax relief)

8

Medicaid Implementation by State

9

Medicare

 $716 Billion Raided From Medicare To Fund Law  Medicare Advantage Cuts Totaling At Least $308 Billion

Over 10 Years – Could Impact More Than 14.5 Million Beneficiaries

 IPAB Could Curb Seniors’ Access To Preferred Health

Care Services; Republicans Will Not Appoint Members

 Failed To Address SGR Payment Cliff  Other Unsustainable Cuts To Medicare Providers

(Including Hospitals, Skilled Nursing Facilities, Home Health)

 CMS Actuaries – 15% Of Hospitals Will Go Out Of

Business As A Result Of Obamacare Raid On Medicare

10

ObamaCare Paperwork Burden

 ObamaCare Raises Taxes and Will Cost Trillions, but

There Is Also a Massive Regulatory Burden

 According to the Obama Administration’s Estimates,

Compliance With ObamaCare Regulations Will Take Nearly 190 Million Hours Annually

 40 Million of Those Hours Come From the Small Business Tax

Credit

Tax Increases

False Promises: Premiums

 In 2008, The President Promised To Lower Premiums By $2,500. Since

2008, Premiums Have Grown By $3,000.

 Over 30 Actuarial Studies Since The Law Passed Show Rising Premiums.

Some Will See Increases As Much As 200%.

13

Community Rating Essential Health Benefit Requirements $165 Billion in New Taxes & Fees on Insurance Plans, drugs and medical devices Guaranteed Issue

Premium Increases: Small Group Rate

14

Premium Increases All Over the Map

15

16

Employer Mandate

 Employers with 50 or more full-time employees must

• ffer affordable insurance to employees and their

dependents or pay one of two different penalties.

 The Employer Mandate is confusing employers,

costing jobs and causing a shift from full-time to part- time workers that is hurting the economy

False Promises: Job Growth

Speaker Pelosi stated that the law “will create 4 million jobs, 400,000 almost immediately.”

Employer/ Employee Burdens

• Employer Mandate
• Less Hours for Workers
• Reduction in Employee

Compensation

• Premium Increases

18

The Reality

• 48 % of business owners cite the potential cost of

health care regulations in their decision not to hire additional workers.

• The Federal Reserve reports that employers are citing

unknown effects of Obamacare as reasons for planned layoffs and reluctance.

False Promise : You Can Keep Your Plan

In 2009, at a town hall meeting in New Hampshire, President Obama said, “If you like your health care plan, you can keep your health care plan.”

The Reality

 A survey from McKinsey and Co. found

that 30 percent of employers will definitely or likely drop coverage for their workers in 2014.

 7 million workers will lose their

employer-sponsored coverage according to CBO.

 HHS estimates that up to 80 percent of

small employer plans will lose grandfathered status – triggering new requirements on the coverage Americans have today.

19

Implementation Concerns

 Pages of Regulations Without Definitive

Guidance

 “3 Page Application” for Subsidy or Tax

Credit

 Administration Burden on Private Sector  Will Federal and State Systems be Ready?  Will Consumers Know What to Do in

October?

 Will Employers be Ready?

20

Constituents are going to have a lot of questions!!!

 Congress has a lot questions too – there are more questions than

answers at this point

 Individual mandate

 www.Healthcare.gov  Navigators – will be hired in August

 Exchange subsidies

 http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions  Navigators – will be hired in August

 Employer Mandate

 http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions  NFIB  U.S. Chamber

 Insurance options

 Exchanges – open October 1  Navigators – will be hired in August

RESOURCES



OBAMACARE BURDEN TRACKER (#OBAMACAREBURDEN)



E&C HEALTH CARE ANXIETY INDEX (http://energycommerce.house.gov/healthcareanxietyindex)



WAYS AND MEANS WEBSITE



EDUCATION AND WORKFORCE WEBSITE



PREMIUM INCREASES



Obamacare Oversight: The Looming Premium Rate Shock, May 13, 2013



THE PRICE OF OBAMACARE’S BROKEN PROMISES: YOUNG ADULTS AND MIDDLE CLASS FAMILIES SET

TO ENDURE HIGHER PREMIUMS AND UNAFFORDABLE COVERAGE, MARCH, 2013



JOBS



LATEST FEDERAL RESERVE REPORT ACKNOWLEDGES HEALTH CARE LAW SLOWS HIRING AND CONSUMER SPENDING, INCREASES COST, MARCH 7, 2013



MEDICAID



MEDICAID CHECK UP: REASONS FOR REFORM, MARCH 18, 2013



MEDICAID EXPANSION COSTS TO STATES, MARCH 1, 2011



MEDICARE ADVANTAGE



LETTER TO CMS FROM HATCH, UPTON, CAMP REGARDING CUTS TO MEDICARE ADVANTAGE PROGRAM, FEBRUARY 28, 2013

22