Key health care reform timeline gra panel


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Key health care reform timeline gra panel

  1. 1. AARP Nora Super Director, Federal Government Relations Health and Long-Term Care February 10 , 2010 Building Bridges: Making a Difference in Long‑Term Care Key Health Care Reform Timeline
  2. 2. 2010 <ul><li>Medicare prescription drug “donut hole” $250 beneficiary rebate </li></ul><ul><li>Cracking down on waste, fraud, and abuse – funding, enforcement and screening for providers </li></ul><ul><li>Temporary high-risk pools for those with pre-existing conditions </li></ul><ul><li>Reinsurance for early retirees </li></ul>AARP 2
  3. 3. 2010 (continued) <ul><li>Federal-state process for annual review of premium rates </li></ul><ul><li>Increased federal Medicaid drug rebates </li></ul><ul><li>Medicaid state option to cover adults up to 133% poverty </li></ul><ul><li>HCBS State Plan Option Changes </li></ul><ul><li>Changes to Money Follows the Person Rebalancing Eligibility </li></ul>AARP 3
  4. 4. 2010 (continued) <ul><li>Website with information to help consumers identify affordable coverage </li></ul><ul><li>Various insurance market reforms including ban on lifetime and “unreasonable” annual limits; coverage rescission prohibition; certain preventive services covered with no cost sharing; extension of dependent coverage; appeals; patient protections; no pre-existing conditions for kids; minimum loss ratio reporting for kids; quality reporting; administrative simplification </li></ul>AARP 4
  5. 5. 2011 <ul><li>Income-relating Part D premiums and freezing of income-relating thresholds </li></ul><ul><li>Medicare annual wellness exams and elimination of cost-sharing for preventive services </li></ul><ul><li>Numerous Medicare payment changes (primary care bonus, power-driven wheelchairs, advanced imaging services, home health update reduced) </li></ul>AARP 5
  6. 6. 2011 continued <ul><li>Additional standards for new or “nongrandfathered” health plans </li></ul><ul><li>Medicare, Medicare Advantage benefit and payment reform </li></ul><ul><li>Part D discounts begin in donut hole </li></ul><ul><li>Voluntary LTC “CLASS” program may start </li></ul><ul><li>Community First Choice </li></ul><ul><li>State balancing incentives payments program </li></ul>AARP 6
  7. 7. 2011 (continued) <ul><li>Freezes MA payment rates at 2010 levels </li></ul><ul><li>MA cost sharing restrictions </li></ul><ul><li>Simplification of annual election period (MA to traditional Medicare) </li></ul><ul><li>Money Follows the Person Rebalancing Demonstration extended </li></ul><ul><li>New information about nursing homes begins rolling out on Federal Nursing Home Compare Website including links to state government nursing home websites.  </li></ul>AARP 7
  8. 8. 2012 <ul><li>Waives Part D cost-sharing for full duals in HCBS </li></ul><ul><li>Four-year Medicare Graduate Nursing Education demonstration program begins </li></ul><ul><li>Medicare Hospital Readmission Reduction Program begins </li></ul><ul><li>Hospital value-based purchasing rewards begin </li></ul>AARP 8
  9. 9. 2013 <ul><li>Higher Medicare payroll tax on wages exceeding $200,000/individual; $250,000/couples </li></ul><ul><li>New Medicare tax on net investment income for taxpayers with incomes exceeding $200,000/individual; $250,000/couples </li></ul><ul><li>Mandatory medication therapy management for Part D enrollees with chronic conditions </li></ul>AARP 9
  10. 10. 2013 <ul><li>HHS determines which states will have Exchanges running by 2014, initiates them in States that won’t </li></ul><ul><li>HHS Secretary must award loans and grants for start-up of qualified CO-Ops in each state </li></ul><ul><li>HHS Secretary must issue regulations relating to state compacts for the inter-state sale of health insurance in the individual market </li></ul><ul><li>23% increased CHIP match FY2014-2019 </li></ul>AARP 10
  11. 11. 2014 <ul><li>State exchanges/all major insurance reforms </li></ul><ul><li>Premium subsidies and cost-sharing subsidies for Exchange insurance </li></ul><ul><li>Individual and employer responsibility requirements </li></ul><ul><li>HCBS spousal impoverishment protections </li></ul><ul><li>Medicare Advantage plans must have minimum 85% medical loss ratio </li></ul>AARP 11
  12. 12. 2015 <ul><li>State Exchanges must be self-sustaining </li></ul><ul><li>Minimal cost-sharing in Medigap C and F plans </li></ul><ul><li>States may enroll CHIP kids in Exchange plans </li></ul><ul><li>GAO study on affordable coverage/premium assistance credits </li></ul>AARP 12