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ObamaCare vs Governor's Medicaid Restoration Plan

ObamaCare vs Governor's Medicaid Restoration Plan

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Published by tpmdocs
ObamaCare vs Governor's Medicaid Restoration Plan
ObamaCare vs Governor's Medicaid Restoration Plan

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Published by: tpmdocs on Jun 13, 2013
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07/10/2013

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Governor Brewer
’s
Medicaid Restoration Plan Restores Arizona Law. It is NOT ObamaCare.
Governor Brewer’
s Medicaid plan is designed to comply with Proposition 204, a mandate overwhelminglyapproved by
ARIZONA VOTERS
 that requires AHCCCS to provide healthcare coverage to Arizona childlessadults up to 100% of poverty.
Governor Brewer’s plan is NOT
 
“ObamaC
are.
Below is a side-by-sidecomparison of some of the key components of ObamaCare versus what
Governor Brewer’s plan entails:
 
ObamaCare
Establishes an Individual Mandate.
This changeleads to new mandates aimed at increasingaccess to affordable healthcare coverage. Only some of these are highlighted below.
Changes to Commercial Insurance Market 
-
 
Establishes the Exchange or HealthInsurance Marketplace; enrollmentbegins 10/1/13.-
 
Adds new benefit requirements forcommercial policies on and off theExchange/Marketplace.-
 
Adds new cost sharing restrictions forMarketplace policies.-
 
Extends coverage for young adults in
their parents’ plan until they turn 26
years old.-
 
Establishes guaranteed issue.-
 
Prohibits insurance companies fromdenying coverage to children under 19years due to a pre-existing condition.-
 
Prohibits insurance companies fromrefusing to sell coverage or renewpolicies because of a pre-existingcondition.-
 
Establishes community rating.-
 
Eliminates the ability of insurancecompanies to charge higher rates dueto gender or health status.-
 
Provides tax credits for middle and low-income families to help cover some of the costs of Marketplace coverage.-
 
Provides tax credits for small businessesto help provide insurance benefits fortheir workers.-
 
(…continued on the next page)
 
Governor’s Medicaid
Restoration Plan
Honors the will of Arizona voters
-
 
Restores coverage of Prop. 204 childlessadults (0-100% FPL) as passed by  Arizona voters in 2000, impactingestimated 240,000 Arizonans.
-
 
Covers an additional 57,000 adults from100-133% FPL so that Arizona canaccess enhanced federal funds for Prop.204 coverage.
-
 
Includes a hospital assessment to pay  for the
State’s
share of the cost of care for the Prop. 204 population.
-
 
With use of hospital assessment,reduces Medicaid pressure on State
budget … making more dollars availab
le for critical services like education and  public safety.
-
 
Features circuit breaker that automatically ends the assessment and Medicaid expansion if federal matchingdollars are reduced below an amount established in the legislation.
 
 
Obamacare Continued
 
-
 
Provides federal funding forMarketplace navigators, a consumerassistance program.-
 
Eliminates lifetime limits on insurancecoverage.-
 
Regulates annual dollar limits oninsurance coverage.-
 
Prohibits insurance companies thathave excessive or unjustified premiumincreases to participate in the HealthInsurance Exchange.-
 
Requires all new health plans to covercertain preventive services withoutdeductibles or copays.-
 
Prohibits insurance companies fromrescinding coverage as a result of finding an error or other technicalmistake on an application.-
 
Provides consumers with a way toappeal coverage determinations orclaims with their insurance companiesand establishes an external reviewprocess.-
 
Requires that 85% of premium dollarscollected by insurance companies forlarge employers be spent on health careservices and quality improvement.-
 
Limits the amount health insurancecompanies can deduct from taxes forofficers, employees, directors andservice providers.-
 
Requires health plans to begin adoptingand implementing rules for the secure,confidential, electronic exchange of health information.-
 
Adds a new excise tax on healthinsurance plans valued in excess of $27,500/year, known as
“Cadillac
h
ealth insurance”
.
 
 Obamacare Continued
 
Quality, Payment, Oversight, Funding
-
 
Creates the Center for Medicare &Medicaid Innovation to test new waysof delivering care to patients-
 
Creates special office to improve carecoordination for dual eligibles.-
 
Increases reporting requirements forquality of care measures for healthplans and state Medicaid programs.-
 
Increases Medicaid payments forprimary care doctors.-
 
Provides incentives for providers toform Accountable Care Organizationsand other programs to bettercoordinate care and improve quality-
 
Adds new screening procedures forhealth care providers to fight fraud andreduce waste in Medicare, Medicaid,and CHIP.-
 
Adds Medicare reimbursementpenalties for hospitals.-
 
Includes changes to Medicarereimbursement, including bundledpayment strategies.-
 
Introduces Medicaid payment changes,including value based purchasing andbundled payments.-
 
Includes grant opportunities for publichealth initiatives, such as improvingmaternal and child health outcomes.-
 
Adds a surtax on investment income forhouseholds that make over$250,000/yr.-
 
Adds individual tax mandates onuninsured individuals.-
 
Adds a new tax and penalties foremployers with 50+ employees that donot offer health coverage if anemployee qualifies for a health taxcredit.

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