To Your Health What the ACA Has Meant and Will Mean for Consumers - PDF document

Jul 28, 2023 •187 likes •229 views

To Your Health What the ACA Has Meant and Will Mean for Consumers and Health Insurers NOLHGA 2016 Legal Seminar, July 22, 2016 To Your Health Context The Affordable Care Act is making a positive impact: Covering the uninsured

To Your Health What the ACA Has Meant and Will Mean for Consumers and Health Insurers NOLHGA 2016 Legal Seminar, July 22, 2016 To Your Health – Context… ► The Affordable Care Act is making a positive impact: ► Covering the uninsured (Medicaid expansion, Exchanges) ► Protecting vulnerable consumers (EHB, Market Reforms) ► Facilitating the move to value-based healthcare and care integration ► But significant challenges persist: ► Assuring competition and insurer viability across markets ► Assuring adequate benefits and cost sharing for consumers ► Stabilizing financial assumptions: risk pools, drugs, federal payments ► Ever-growing government obligations (Medicare, Medicaid) ► Healthcare system not pointed toward custodial and long term care ► Lingering political and federalism issues
To Your Health Commissioner Teresa D. Miller, Pennsylvania Insurance Department ► A regulator’s challenges in overseeing health insurance markets that are still adjusting: ► 2017 rate and form review ► Long-term care insurance ► Non-MEC health insurance products ► Consumer protections (surprise bills and related topics) ► The role of the NAIC and DOIs in challenging times To Your Health Patricia M.C. Brown, President, Johns Hopkins HealthCare LLC ► Opportunities for Provider-Insurer integration amidst challenges: ► Integrated health systems are positioned to move into insurance ► Emerging value-based insurer-provider partnerships ► Offering products across markets (i.e., government programs) to mitigate risk in ACA markets ► Provider-centric considerations about managing risk, and maintaining solvency
To Your Health Earl R. Pomeroy III, Alston & Bird LLP (former Congressman and President of NAIC) ► Washington DC considers a challenged health insurance environment ► Comments on bi-partisan embrace of value-based and managed care payment models ► Comments on GOP and Clinton health care plans ► Comments on insurer, state, and House vs. DHHS lawsuits ► What can be done to address the challenges facing the public exchanges To continue the discussion… ► Mike Adelberg, Senior Director, FaegreBD Consulting Michael.adelberg@faegrebd.com ► Commissioner Teresa D. Miller, Pennsylvania Insurance Department termiller@pa.gov ► Patricia M.C. Brown, President, Johns Hopkins HealthCare LLC Pbrowna@jhmi.edu ► Earl R. Pomeroy III, Alston & Bird LLP Earl.Pomeroy@alston.com

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