Welcome to the first legislative update from HealthPartners!

The federal health care reform debate is evolving every day and it can be hard to keep up.  The following is the first edition of a newsletter intended to provide updates to you on federal health care reform. In recent discussions with employers on this topic, here's what we have heard matters to you:

  • Employers are concerned about the increasing costs of health care.  While it’s important to make health care accessible for everyone, the cost of health care must also be addressed to make reforms sustainable.
  • Medicare payment inequity needs to be addressed to reward quality rather than quantity.
  • Reform needs to engage consumers and providers in improving the cost and quality of care.
  • Affordable coverage for all can be best achieved by building on and strengthening the employer-based system.
  • Flexibility in employer-based benefit designs that include wellness incentives and the ability to control health care costs is important.  ERISA provisions have been successful in allowing this flexibility and we need this to remain in any health care reform legislation.

We’re using this feedback to inform our discussions with federal lawmakers about reform. Additionally, these are the topics we will focus on in this publication. Welcome to the first edition!

HealthPartners is a non-partisan organization.

 

 

What’s going on in Washington D.C. now?

Things are moving quickly in Congress on health reform – the House committee is expected to wrap up its work this week and then Congressional leaders will have to combine the bills into a House and Senate version, successfully pass them off the floor, hammer out the differences between the two and present a bill to President Obama by the end of the year.  That final product will likely combine elements of both the House and Senate bills.

Here are some of the key open questions that we see for employers:

  1. Pay or play
    Will employers have to provide health benefits to employees, or pay a penalty?  Liberal Democrats say yes. Moderate Democrats are unsure. Republicans are generally opposed. The House will likely call for an employer mandate and the Senate probably will not.

  2. Funding
    The Congressional Budget Office estimates that reform proposals would cost at least $900 billion over 10 years. President Obama insists that reform will not add to the deficit. The House wants additional tax on high-income people, while the Senate proposed an excise tax on high-cost insurance plans (which would likely be passed on to employers in the form of higher premiums).  There will also likely be new taxes on device and pharmaceutical manufacturers, along with large reductions in the Medicare program and payments to hospitals.

  3. Acceptable levels of coverage
    Both the House and Senate have similar language that would set standard rates of how much insurance covers (as opposed to how much an individual is responsible for). Requiring insurance to cover more will make insurance products more expensive.

  4. The public option
    Democrats are divided over how and if they can create a government-run plan to compete with private insurance companies. The more liberal House will probably not pass a health care bill without such a public insurance option, while the Senate appears unlikely to pass one with it.

  5. Individual insurance mandate
    This is a controversial proposal, since the penalties for violations will likely be collected by the IRS. Many lawmakers want to minimize the requirement, although this raises the concern that people will only enroll if they become sick. Both the House and Senate bills will require Americans to carry insurance.

  6. Bending the cost curve
    Every proposal to reduce the cost of health care meets resistance from health care providers who fear a loss of income, even as they stand to gain millions of paying customers if nearly everyone has insurance. Both the House and Senate proposals will likely contain some method to link provider payment to outcomes, but it remains to be seen how strong these proposals will be. Failure to do so will likely mean that any health reform is unsustainable in the long run.

As you can see, there are a lot of open issues the government will need to work out over the coming months. Watch for future editions with more information on these key issues!

 

 

HealthPartners Public Policy Platform

We get a lot of questions about where HealthPartners stands on health care reform. HealthPartners public policy position is designed to achieve the “Triple Aim”– to simultaneously optimizing the health of members, the patient experience and reducing the per capita costs of care. 

In alignment with the “Triple Aim,” we’d like to see health care reform address the following key issues:

  • Everyone should have affordable health care coverage.
  • Payment systems must reward value, (quality and efficiency) not volume.
  • Quality, costs and incentives should be as transparent as possible.
  • Reform of federal and state regulation is needed to support and encourage an effective market.
  • Government policy should encourage healthy lifestyles and support health promotion.
  • Government should establish public health goals, and strengthen the role of the public health system.

Learn more about HealthPartners Public Policy Platform.

 

 

Worthwhile readings on health care reform

There is a lot of media coverage of health care reform.  Many articles and publications provide a breakdown of what is and is not working in the current health care system. Here are some of our favorites:

  1. The New Yorker, June 2009
    “Annals of Medicine – The Cost Conundrum” by Atul Gawande

  2. The Atlantic, September 2009
    “How American Health Care Killed my Father” by David Goldhill

  3. McKinsey Global Institute, November 2008
    “Accounting for the cost of U.S. health care: A new look at why Americans spend more”

 

 

What can you do with this information?

The information in this newsletter is intended to keep you informed about the latest developments in the health care reform debate. If you find this information helpful, feel free to use it in your communications with colleagues and employees.

 

 

 

 

If you have any questions about health care reform and how it might affect your organization, please feel free to contact Geoff Bartsh, HealthPartners Director of Government Relations.

Watch for additional legislative updates as more information becomes available!