Summary points of health care reform

A nice summary

(1) Expands coverage to about 33 million people by 2014 (50% private, 50% public support); 95% eligible Americans would be covered: 83% now

(2) Does this by a combination of expanding Medicaid coverage, mandating that all individuals be covered (with certain exemptions), and mandating that private businesses cover workers for firms with >200 employees (WalMart issue)

(3) Estimated costs of $965 billion/10 years

(4) Pays for expansion by combination of increased revenues and cost containment

(5) Lets states create insurance exchanges to broaden and cheapen insurance options for those not covered

(6) Extensive and income-adjusted subsidies for low income families

(7) Penalizes employers that don’t provide coverage

(8) Expands Medicaid coverage to all under 65 population with incomes <133% of Federal Poverty Level

(9) Require states to maintain CHIP thru 2015

(10) Increases taxes on high income persons, beginning 2011

(11) Cracks down on Medical Savings Accounts, “Cadillac insurance plans” and Medicare Advantage Plans (to get new coverage $)

(12) Some charges to health insurance plans and pharma

(13) Health insurance reform
--Eliminates preexisting conditions
--Jawbones insurance plans re “loss ratio” (>85%)
--Kids can stay on parents’ plans until age 26
--Eliminates lifetime expenditure caps
--Covers prevention services
--Gradually closes the doughnut hole for Medicare Part D

From Steven A. Schroeder, MD from talk: Revisiting American Health Policy: Why Change Comes so Hard