House Health Care Reform Bill Summary Available - June 23, 2009

On Friday, June 19, the House committees of jurisdiction (Education and Labor, Energy and Commerce, and Ways and Means) released a draft of their health reform bill, referred to as the “Tri-Committee bill,” that includes a number of items of interest to NAPH members. The full text of the bill is available online. NAPH counsel Ropes and Gray has prepared a four-page summary of the bill, focused on areas of interest to NAPH members. Of particular interest to public hospitals:

• Individual Mandate: Requires individuals to obtain insurance, providing “affordability credits” for low-income individuals.
• Employer Mandate: Imposes “pay or play” requirements for employers to provide insurance to their employees.
• Health Insurance Exchange: Creates a Health Insurance Exchange, which would be operable in 2013.
• Medicaid Expansion: Expands Medicaid eligibility to individuals with incomes up to 133% of the federal poverty level, with the federal government paying for 100% of the cost of expanded eligibility.
• No DSH Cuts: Preserves Medicaid and Medicare Disproportionate Share Hospital (DSH) payments. Requires the Secretary of Health and Human Services to issue a report in 2016 on the role of DSH in a reformed health care environment.
• GME Redistribution and Reform: Redistributes unused Medicare Graduate Medical Education positions to be used as primary care residency positions.
• Medicare Hospital Payment Cuts: Reduces the annual Medicare market basket update by 1.3% in perpetuity. Combined with the FY 2010 Medicare Inpatient Prospective Payment System Rule (IPPS), would result in a 2% reduction in the annual update in 2010.