The Evolving Health Policy Landscape: What’s in Store for 2018 Winnetka Rotary November 16, 2018 Peter W. Butler Professor and Chairman, Department of Health Systems Management Rush University
Health Care Back in the Forefront
New End-Arounds Pushing for Greater Health Care Coverage “Maine just resoundingly became the first state to expand Medicaid by ballot initiative” Washington Post November 8, 2017
Tax Reform (Maybe), Then Along Comes a December 8 Government Shutdown? Potential issues on the December 8 government funding bill: • Spending caps • CHIP reauthorization (9 million kids with coverage) • Obamacare CSR subsidies to stabilize marketplaces • DACA (Dreamers) • Funding for the border wall • Hurricane relief Best bet may be another stop gap funding bill to punt issues to January
Government Versus Private Market Bernie Democrats Sanders Private Government Current State Market Run Employer- Individual Medicare Medicaid Based (exchanges) 55 million 74 million 155 million 18 million Rand Republicans Paul
How Many People Should Have Coverage? CBO Weighs In and Changes the Trajectory
Most Want Bi-Partisan Effort
Public Opinion Moving to the Left
Where You Live Matters There is up to a 16-year gap in life expectancy between the Loop and West Side neighborhoods
Bi-Partisan Support for Addressing Drug Pricing
Current Balance of Power in Congress Paul Ryan Kevin McCarthy Nancy Pelosi (R-WI) (R-CA) (D-CA) U. S. Senate Speaker of the House Majority Leader Minority Leader 52 Republican 46 Democrat 2 Independent U. S. House of Representatives Mike Pence 240 Republican Mitch McConnell Chuck Schumer (R-IN) (R-KY) (D-NY) 194 Democrat U.S. Vice President Majority Leader Minority Leader Senate President 1 Vacant 13
Congressional Election Landscape 2018 14
Congressional Election Landscape 2018 House Races 2018 Source: Roll Call 15
Illinois General Assembly Illinois House D R 67 51 Seventy-one votes are needed to override a Governor’s veto in the House. Illinois Senate Speaker Madigan D R 37 22 Thirty-six votes are needed to override a Governor’s veto in the Senate. President Cullerton 16
Illinois – Election Landscape 2018 $200 Million Governor’s Race??? Governor Bruce Rauner (R) J. B. Pritzker (D) Chris Kennedy (D) incumbent candidate candidate Chris Kennedy (age 54) is Chair of Joseph P. Jay Robert Pritzker (age 52) is managing partner and Kennedy Enterprises, Inc. He is a son of former co-founder of the Pritzker Group, a private investment U.S. Senator Robert F. Kennedy. His personal net Bruce Rauner (age 60) is the 42nd Governor of firm , and president of the Pritzker Family Foundation, worth is unknown, but the estimated Kennedy Illinois. Prior to his election, he was the Chairman which funds innovative research and programs family net worth is $1 billion. He served as Chair of R8 Capital Partners and Chairman of the private serving children in poverty. He is a member of the of the Board of Trustees for the University of equity firm GTCR. On November 4, 2014, Rauner well known Pritzker family who own the Hyatt Hotel Illinois from 2009 to 2015. Until April 2012, he was won the election, beating Democratic incumbent chain. JB’s estimated personal net worth is $3.4 president of Merchandise Mart Properties, a Pat Quin, with 50.27% of the vote. He carried billion. He graduated Duke University and commercial property management firm. In May every county except Cook. Rauner's net worth is Northwestern University School of Law. He is the 2012, Kennedy founded Top Box Foods, a Chicago- estimated at several hundred million dollars. He father of two children with his wife of 24 years. based hunger-relief non-profit. He has served on accepts only $1 in salary and no benefits from his Pritzker served as national co-chairman of the 2008 the Executive Committee for the Chicago office. His philanthropic endeavors projects for Hillary Clinton for President campaign and as a Community Trust, and has been a board member the Red Cross , the YMCA, charter schools, and delegate to the 2008 & 2016 Democratic National of the Catholic Theological Union, Interface, Inc. scholarship programs for disadvantaged public Convention. He supported President Barack Obama in and Knoll Inc. He has also served as Chairman of school students. He is a graduate of Dartmouth the 2008 general election and helped unite the the Board of the Greater Chicago Food Depository, College and earned his MBA at Harvard University. Clinton and Obama campaigns in Illinois. In 1998, he and is a member of the board of trustees for Ariel He is the father of three children from his first finished third among five candidates in the Investments. Kennedy graduated Boston College marriage and three children with his wife, Diana, Democratic primary in Illinois's 9th U.S. Congressional and earned his MBA at Northwestern University. president of the non-profit Ounce of Prevention District. 17 He is the father of four children with his wife of 30 Fund. years.
The move from volume to value The move away from a fee-for-service is growing as insurance risk tied to per capita spending is being passed along from government to insurers and providers. Over 30% of Medicare Beneficiaries Are Enrolled in a Medicare Advantage Health Plan
The Looming Impact of Baby Boomers Too Few Workers To Support Social Security and Medicare (Part A) through FICA
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