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Employer, Medicare Provisions of House Health Care Reform Detailed in New CCH Briefing
Date:11/13/2009

care options that will include private plans, health co-ops, and a new public health insurance option. It also provides "affordability credits" for low-income individuals to help pay for the cost of coverage purchased through the Exchange, available on a sliding scale linked to the federal poverty limit.

The public option would be administered by the Secretary of Health and Human Services, who would negotiate rates for participating providers. The public health insurance option would have startup administrative funding, but would be required to amortize these costs into future premiums to ensure operation on a level playing field with private insurers.

"The public option is one of the more controversial parts of the House version of health care reform, and likely will be modified as the measure moves through the Senate and then the Conference Committee," Huth said.

Medicare, Medicaid Affected

A significant part of the House bill is devoted to changes in Medicare and Medicaid, according to Paul Clark, senior Medicare analyst with Wolters Kluwer Law & Business.

"Medicare and Medicaid involve huge amounts of money, and savings in these programs can help finance other parts of the reform program," Clark said. "In addition, by setting standards of what it will and will not pay for, Medicare/Medicaid can affect the entire health care system, encouraging efficient and cost-savings practices in the treatment of all patients."

Changes include reducing payments to Medicare Advantage providers, eliminating the "donut hole" in Part D drug coverage, incentives and procedures to reduce readmissions to hospitals and changes in reimbursement formulas to encourage greater use of primary care physicians and less use of specialists. Unfilled residency positions would be redistributed to encourage training of primary care physicians, also.

"Over the past 10 years, nearly all of the graduate medi
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SOURCE Wolters Kluwer Law & Business
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