Election 2004: What Will Happen to Health Insurance?

Transcription

1 A Blue Cross and Blue Shield Association Presentation Election 2004: What Will Happen to Health Insurance? Rowen B. Bell, FSA, MAAA Southeastern Actuaries Conference Savannah, Georgia November 11, 2004 Brand Protection and Financial Services

2 Sources of Health Care Coverage 2003 Census Bureau health insurance estimates: Total population = 288 million Private, employment-based = 174 million Private, directly purchased = 26 million Medicare = 39 million Medicaid = 36 million Military programs = 10 million UNINSURED = 45 million (up from 39 million in 2000)

3 The Uninsured BCBSA white paper (2003) on the uninsured: AAA issue brief (2003) on the uninsured: Categories of uninsured (per AAA): eligible for public programs financially uninsured voluntary financially uninsured unaffordable high-risk poor non-citizens

4 Health Industry Environment Observations on the private insurance market: Changing role of insurer importance of networks de-emphasis emphasis of heavily managed care / HMO models small group/individual (insured) vs. large group (self-funded) funded) Affordability concerns continued cost, utilization increases why? benefit buydowns,, cost-shifting shifting to employees Fundamentally, it s a local business

5 Health Care & Politics, Medicare Modernization Act (2003) Medicare Part D (prescription drugs) Medicare Advantage Health Savings Accounts Association Health Plans (not enacted) Patients Bill of Rights (not enacted) Trade Adjustment Act (2002) introduction of Health Coverage Tax Credit HIPAA Administrative Simplification Prescription Drug Reimportation

6 Kerry vs. Bush BUSH: Encouraging the private market Lewin Group American Enterprise Institute DECREASE IN UNINSURED 10-YEAR COST 8.2 million $0.23 trillion 6.7 million $0.13 trillion KERRY: Increasing federal involvement Lewin Group American Enterprise Institute DECREASE IN UNINSURED 10-YEAR COST 25.2 million $1.25 trillion 27.3 million $1.50 trillion

7 Kerry Health Care Platform Premium rebate pool (i.e., federal stop-loss) Expansion of Medicaid Congressional Health Plan (FEHBP expansion) Refundable tax credits to employers, individuals Electronic medical records (by 2008) Medical malpractice reform (no caps on awards) Diminished enthusiasm for MMA reforms?

8 Bush Health Care Platform Association health plans Individual market reform crossing state lines Deductions & refundable credits to promote HSAs Electronic medical records (funding?) Medical malpractice reform (with caps) Full speed ahead on MMA reforms

9 Election Exit Polls 8% of electorate thought health care was the #1 issue (5 th place); they voted for Kerry Based on level of concern about availability and cost of health care: CONCERN BUSH KERRY Very (70%) Somewhat (23%) Not Very / Not At All (7%) 84 15

10 Post-Election Poll Results BCBSA-commissioned polls 1000 consumers were polled Nov doctors were polled Nov 3-43 Poll results released Nov 10 at BCBSA/Forbes seminar on future of health care For archived webcast of seminar, please see: bcbshealthissues.com/events/.com/events/forbes/

11 Post-Election Consumer Poll What should be the top health care priorities of the new Congress? 1. Increasing access to health care coverage (68%) 2. Prescription drug affordability (67%) 3. Slowing down the rise in health care costs (63%) 4. Reducing health care fraud & abuse (56%)

12 Post-Election Consumer Poll How should Congress address the uninsured? 1. Direct assistance to individuals (52%) 2. Tax credits to small businesses (51%) 3. Expand federal insurance programs (50%)

13 Post-Election Consumer Poll What are the leading factors behind the rise in health care costs? 1. Prescription drugs (60%) 2. Hospital costs (51%) 3. Medical malpractice insurance & lawsuits (48%) 4. Waste, fraud & abuse (44%)

14 Post-Election Provider Poll What are the leading factors behind the rise in health care costs? 1. Medical malpractice insurance & lawsuits (71%) 2. Aging of the population (42%) 3. Prescription drugs (42%) 4. Poor health habits (37%)

15 Post-Election Provider Poll What should be the top health care priorities of the new Congress? 1. Medical malpractice reform (80%) 2. Increasing access to health care coverage (43%) 3. Encouraging healthier lifestyles (43%)

16 Outlook Regulatory reform AHPs? individual market? other approaches? Tax reform tax credits? more broad-based based reforms? Medical malpractice / tort reform Health information technology