understanding health reform choice regional health network

Understanding Health Reform

CHOICE Regional Health Network

Health ReformAn overview of the impact of the

Patient Protection and Affordable Care Act in the United States

Federal Poverty LevelHigh-risk Pool

Health Insurance ExchangeInsurance SubsidiesIndividual MandateEssential Benefits

1. Sources of coverage

Health Reform

more Americans with health insurance coverage

more Americans with health insurance coverage

Source of coverage Now 2014 Change

Employer 59% 57% -2%

Individual Private 6% 2% -4%

Other 3% 3% None

Medicaid/CHIP 15% 18% +3%

Uninsured 17% 6% -11%

Exchange 0% 14% +14%

1. Sources of coverage2. Financial Implications

Health Reform

health reform is intended to be budget reducing

Fees, Taxes and Penalties

Medicaid

Insurance Premium SubsidiesMedicare Savings

+/- 1 trillion +/- 1 trillion

1. Sources of coverage2. Financial Implications3. Major change components

Health Reform

Changes in Public

Coverage

Changes in Public

Coverage

Changes in Private

Coverage

Changes in Private

Coverage

Improving Health Care

Quality

Improving Health Care

Quality

Improving Health

Improving Health

Medicaid expansion

Changes in Public

Coverage

Changes in Public

Coverage

Insurance RegulationHealth Insurance Exchanges

Changes in Private

Coverage

Changes in Private

Coverage

Best information

Coordinated careProvider incentives and penalties

Improving Health Care

Quality

Improving Health Care

Quality

National health strategyResearch and public health innovationMandatory preventative careHealthier communities

Improving Health

Improving Health

1. Sources of coverage2. Financial Implications3. Major change components4. Timeline

Health Reform

2010 2011 2012 2013 2014

Insurance Regulation

Tax and Spending Changes

Insurance Regulation

Tax and Spending Changes

2010 2011 2012 2013 2014

Improving Quality Measures

Additional Tax and Spending Changes

Improving Quality Measures

Additional Tax and Spending Changes

2010 2011 2012 2013 2014

Reduced Payments – Medicare

Quality Incentives and Demonstration Projects

Reduced Payments – Medicare

Quality Incentives and Demonstration Projects

2010 2011 2012 2013 2014

Additional Tax and Spending Changes

Additional Tax and Spending Changes

2010 2011 2012 2013 2014

Coverage Expansions

Individual Mandates Enacted

Additional limits, fees, incentives

Coverage Expansions

Individual Mandates Enacted

Additional limits, fees, incentives

2010 2011 2012 2013 2014

Changes in 2015 and beyondChanges in 2015 and beyond

1. Sources of coverage2. Financial Implications3. Major change components4. Timeline

Health Reform

What questions for clarification do you have?

The EndPresented by: Kristen West

westk@crhn.org