OBAMACARE 101 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
How Did We Get Here? 2 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
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So, What’s in it? 4 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 one of two different penalties. $1.1 Trillion In New Taxes ; Including Taxes On Medical Devices, Drugs, Insurance Premiums, “Cadillac” Plans, Unearned Income
So, What’s in it? 5 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
2014: “State” Exchanges 6 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
State Decisions For Creating Health Insurance Exchanges As Of May 2, 2013 7 26 7 18 http: Kaiser Family Foundation, statehealthfacts.org
2014: Medicaid Expansion 8 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)
Medicaid Implementation by State 9
Medicare 10 $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
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 13 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%. Essential Health Benefit Guaranteed Requirements Issue Community Rating $165 Billion in New Taxes & Fees on Insurance Plans, drugs and medical devices
Premium Increases: Small Group Rate 14
Premium Increases All Over the Map 15
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Employer Mandate Employers with 50 or more full-time employees must offer 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
18 The Reality False Promises: Job Growth • 48 % of business owners cite the potential cost of health care regulations in their decision not to hire Speaker Pelosi additional workers. stated that the • The Federal Reserve reports that employers are citing law “will create 4 unknown effects of Obamacare as reasons for planned million jobs, layoffs and reluctance. 400,000 almost immediately.” • Employer Mandate • Less Hours for Workers Employer/ • Reduction in Employee Employee Burdens Compensation • Premium Increases
19 The Reality False Promise : You Can Keep A survey from McKinsey and Co. found Your Plan that 30 percent of employers will definitely or likely drop coverage for their In 2009, at a town workers in 2014. hall meeting in New Hampshire, 7 million workers will lose their President Obama employer-sponsored coverage according said, “If you like to CBO. your health care plan, you can keep your health care HHS estimates that up to 80 percent of plan.” small employer plans will lose grandfathered status – triggering new requirements on the coverage Americans have today.
Implementation Concerns 20 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?
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
R ESOURCES 22 O BAMACARE B URDEN T RACKER (#O BAMACARE B URDEN ) E&C H EALTH C ARE A NXIETY I NDEX (http://energycommerce.house.gov/healthcareanxietyindex) W AYS AND M EANS W EBSITE E DUCATION AND W ORKFORCE W EBSITE P REMIUM I NCREASES Obamacare Oversight: The Looming Premium Rate Shock, May 13, 2013 T HE P RICE OF O BAMACARE ’ S B ROKEN P ROMISES : Y OUNG A DULTS AND M IDDLE C LASS FAMILIES S ET TO E NDURE H IGHER P REMIUMS AND U NAFFORDABLE C OVERAGE , M ARCH , 2013 J OBS L ATEST F EDERAL R ESERVE R EPORT A CKNOWLEDGES H EALTH C ARE L AW S LOWS H IRING AND C ONSUMER S PENDING , I NCREASES C OST , MARCH 7, 2013 M EDICAID M EDICAID CHECK UP : REASONS FOR REFORM , M ARCH 18, 2013 M EDICAID EXPANSION COSTS TO STATES , MARCH 1, 2011 M EDICARE A DVANTAGE L ETTER TO CMS F ROM H ATCH , U PTON , C AMP R EGARDING C UTS TO M EDICARE A DVANTAGE P ROGRAM , F EBRUARY 28, 2013
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