Prospects for Federal Health Legislation

2008 Health Care Forecast Conference

February 21, 2008

Terri ShawThe Children’s Partnership

Overview

Context for (in)action this year Prospects for Congressional action Prospects for Executive action

Context for (In)Action

On the one hand… Election year Veto threats Pay-go

Context for (In)Action

On the other hand… “Must-do” items Executive activism Health care continues to be a high-priority

item for voters

Prospects for Congressional Action

“Must-do” items– Health

Medicare Medicaid/SCHIP

– Not directly/exclusively health-related Economic stimulus AMT and tax extenders Appropriations No Child Left Behind?

Prospects for Congressional Action

Pending/unfinished items:– CHAMP Act

SCHIP reauthorization Physician and other provider reimbursement changes Reduce Medicare Advantage overpayments Beneficiary improvements Eliminate self-referral to physician-owned hospitals Repeal trigger

– Mental health parity– Genetic non-discrimination– Health IT– Comparative effectiveness

Prospects for Executive Action:Seven Medicaid Proposals Last Year

Proposal Status

School-based services Moratorium until 6/30/08

Rehab services Moratorium until 6/30/08

Targeted case management Effective 3/3/08; moratorium until 3/09 included in S1200

Hospital cost limits Moratorium until 5/25/08

GME Moratorium until 5/25/08

Outpatient services To be finalized early 2008

Provider tax Effective 1/1/08

Cumulative savings: $15B over 5 years

Source: Center on Budget and Policy Priorities, February 13, 2008

Prospects for Executive Action

Regulatory proposals in the President’s budget include:– Medicaid/SCHIP:

Specify allowable Medicaid managed care savings Additional SCHIP/Medicaid restrictions?

– Medicare: Reimbursement for hospitals, SNFs, hospice Program integrity

Others?