§§1501, 10106; HCERA §§1002, 1004

Your New Health Care System

§3021
§5605

§3403, 10320
§6301
§6301
§8002
§1411
§4002

President

§8002

§8002

§8002

§8002

§8002

§3012

§1411

§1313, 10104

§1313, 10104

§§1322, 10104

§1322, 10104

Private
Purchasing
Council
§1322

Internet
Portal
§1311

§§1201, 1301,1302, 1311, 1312, 1313,
1321, 1323, 1334, 1411, 1413, 10104;
HCERA §1204

Small Business
Health Options
Program

Data
Collection

§1311

§1311

§2602

§1001, 10101

MEWA
Health Plans

§1511
§1512

§1311

§§9015, 10906; HCERA §1402

Rationing Potential

Mandates

Involvement in Health
Insurance Market

Taxes & Monetary Fees/
Penalties/Cuts
Trust Fund
(Rationing Potential)
Other New Trust Funds/
Monetary Benefits

Government with
Expanded Authority/
Responsibility

Mandates, Regulations,
& Taxes

Government Financial
Entity with New Inflows/
Outflows
State/Territory with
Expanded Authority/
Responsibility

Regulations/
Requirements/Mandates
Reporting Requirements

Unchanged
Private Entity

Money Flows
Consultation/Advisory/
Info Sharing
Structural Connections
(Includes Existing)

Special Interest
Provisions

Oversight

10%
Tax On
Indoor Tanning
Services:

§1512
§§9017, 10907

§§1311, 1411, 1501, 9003-9005, 9013,
9015, 9017, 10106, 10902, 10906, 10907;
HCERA §§1002, 1004, 1402, 1403

§§9017,
10907
§9013

Flexible Spending
Arrangement
§9005, 10902; HCERA §1403

§§9005, 10902; HCERA §1403

New Relationships

Private Entity with
New Mandates/
Regulations/
Responsibilities

§§1421,
10105

Small Business
Employees

Individuals

§3311

Private

Small
Business
Health Insurance
Tax Credit

FSA
Contribution
Limit: $2,500
§§9005, 10902;
HCERA§1403

Patients

Only
Medical Expenses
Above 10% of Income
(AGI) are Tax
Deductible

§§9010, 10905; HCERA §1406

Medicare
Beneficiaries
§3311

Expanded Government

§1421, 10105

§§9015, 10906;
HCERA §1402

§§1304, 1311, 1421, 1512,
10105

§1512

§9003

§9002

HCERA §1402

Medicare
Payroll Tax
Increase: 0.9%

Large Business
Employees

§§1501, 10106;
HCERA §§1002, 1004

Small Employers

§§1511, 1512, 1513, 9001, 9002,
10106, 10901; HCERA §§1003, 1401

§1511, 1512

3.8%
Investment
Income Tax

§9004

§1511

HSA
Use Restriction

§1513, 10106

§1512

Misuse of
HSA Funds

Mandates, Regulations,
& Taxes

§1501

§3311
§3311

§§1401, 1412, 10105;
HCERA §§1001,
1004

§§1513, 10106; HCERA: §1003

§§1201, 1301

§3311

§3004

§§1001, 10101

§3004
§3004
§3004

New Government

§§1514, 10106

§3301; HCERA
§1101

Health Insurance
Policy Holder

Individual
Mandate:
Buy Health
Insurance

§§9001, 10901;
HCERA §1401

§1411

§2701

“Cadillac
Plans” Tax

§§1001, 10101

§1301

§§9001, 10901; HCERA §1401

§§9001, 10901; HCERA §1401

§§9003, 9004

§§1001, 10101

Self-Insured
Health Plans

Employers

Health Savings
Accounts

“Excessive
Profits”
Premium
Tax Credit
Subsidies

§§1304, 1511, 1512, 1513,
1514, 10106

HCERA §1402

Subsidy:
Medicare Part D
Drug Program
“Donut Hole”

§3007
§3004
§3004
§3004
§3004
§3004

Medicaid
Quality
Measurement
Program

§§1402, 1412;
HCERA
§1001

§9002

§1511

§9004

§3004, 3005

§3301; HCERA §1101

§2701

Subsidies:
Out-of-Pocket
Expenses

W2
Health
Insurance
Disclosure

§§1513, 10106;
HCERA §1003

Large Employers

§§1201, 1301, 1511

§§1001, 1201, 1252, 1301, 1334, 1341,
3311, 9001, 9010, 10101, 10104, 10901,
10905; HCERA §§1401, 1406

§9003

§§3007

Hospital
Quality
Reporting
Program

Medicare
Prescription Drug
and MA-PD
Complaint System

§§3201, 10318; HCERA
§1102; CBO Cost
Estimate,
3/20/10

§1511

Large Group
Market

Mandates, Regulations,
Required Benefits, &
Taxes

§§1001, 10101

§§3007

§3311

§§9010, 10905;
HCERA §1406

§§1401, 1412, 10105; HCERA §§1001, 1004

§§3002, 10327, 10331
§§3002, 10327, 10331

Physician
Value-Based
Payment
Modifier

Title III;
CBO Cost Estimate,
3/20/10

Medicare
Advantage
Cuts: $205.9bn

§2701

StateSpecific Adult
Health Quality
Measures

(includes MA cuts)

§§3201, 10318; HCERA §1102

Title III, §2602

§2701

§2701

§§3002, 10327,
10331

Hospital
Compare
Website
§3001

Annual Fee

§2701

§3004

Physician
Quality
Reporting
System

Medicare
Cuts: $528.9bn

§§9010, 10905; HCERA §1406

§2701

§3004

§3005

§§1311, 3002, 3003, 10327, 10331

Long-Term
Care Hospitals

§3005

Inpatient
Rehabilitation
Facilities

§3005

Physicians

§3005

Medicare

Title III

Medicare
Part C & Part D
Insurers

§2701

PPS-Exempt
Cancer Hospitals

§3004

§§2602, 2701, 2703,
3011

§3022, 10307

§§1201, 1301, 1304

Employer
Mandate:
Provide Health
Insurance

Mandatory
Worker AutoEnrollment

§1301, 1304, 1342

Health Insurance
Companies

§3311

§2701

Hospice
Programs

§3007

§2602

§§3001, 10335

§§3004, 3005

§3311

§§1311

§2703

State
Medicaid
Agencies

§§2001-2004
CBO Cost Estimate,
3/20/10

§3001

Hospital
Value-Based
Purchasing
Program

Medicare
Administrative
Contractors

§§1311, 3001-3006, 3311, 9008, 9009,
10327, 10331, 10335, 10904; HCERA
§§1404, 1405

Public Data
Disclosure
System
§3006,
10301

§§3022, 10307

§3006

§§3001, 10335

§§3006, 10301

§1511

§§1311, 3001, 10335

§§3001, 10335

§2703

Medicaid
Expansion:
+16 million

§1342

Hospitals

Mandates, Regulations,
Taxes, & Payment Cuts

Demonstration Program
§3001

§§3001, 10335

Small Group
Market
§§1514, 10106

§§1402, 1412; HCERA §1001

Health Industry

§1341, 10104

§§3006, 10301

Title II; §§1413, 3011

§§1301, 6605

§1201, 1301, 1304, 1342

§2703

§§3006, 10301

Medical Device
Manufacturers

Medicaid/
CHIP

FFS
Accountable
Care
Organizations
Program

17

§1334, 10104

§§3006, 10301

Medicaid
Health Home
Program

§2602

§§2001-2004

NonHospital
Value-Based
Purchasing
Program

§§3006, 10310

§§1311, 1413

§§3021, 10305,
10306

§§3013, 3021, 3026,
3403, 10305, 10306,
10320

§3021

Individual Market

§6605

§§1201, 1301, 1304

§2703

§§3006, 10301

Skilled Nursing
Facilities

CMS

§2602

§2602

§§3022, 10307

§§9009, 10904

§9008; HCERA §1404

§§9009, 10904; HCERA §1405

Ambulatory
Surgical Centers

Center
for Medicare
& Medicaid
Innovation

§§1001, 1101,
1201, 1251,
10101,
10103;
HCERA
§2301

§§1001, 10101

4

§3403

§3026

§2602
§3011

Medical
Device
Excise Tax

§§1331, 3403, 10104

§3026

5 2 0 3 , 52 0 4 , 5 20 5 ,
5311

§3403, 10320

CommunityBased Care
Transitions
Program

§2703

§§3021, 10305, 10306

§§9015, 10906; HCERA §1402

Loan
Repayment
& Forgiveness
Programs

Federal
Coordinated
Health Care
Office

CMS
Actuary

§3026

§3026, 6301

Insurance
Mandates

§1342

§3013

§§9001, 10901; HCERA §1401

Risk
Corridors

§1342

§1334, 10104

§1513, 10106

Medicare
Part B Trust
Fund

§§3403, 10320

Health
Insurance
CO-OP

§1322

§1421, 10105

CO-OP
Advisory
Board

§§1322, 10104

§§1341, 10104

§1321

§1313, 10104

§1322

§§1501, 10106; HCERA §§1002, 1004

§1313, 8002,
10104

§§9004, 9005; HCERA §1402

§§1341, 10104

§§1341, 10104

§§1311, 10104

§§1311, 10104

§1411

§1411

§3001

§§1401, 10105

§§1311, 10104

§§1331, 10104

§1323; HCERA §1204

§1323; HCERA: §1204

Government
Health Benefit
Exchanges

§1342

§§3403, 10320

Represents Bundles of
Additional Entities

US
Territories

§1323; HCERA: §1204

§3026

IPAB
Consumer
Advisory
Council

Other Expansions

§1331, 10104

§1001

Eligibility
Determinations

§1411

HHS
Inspector
General

§1411

§§3403, 10320

§§1341, 10104

§1411

§1561

§4302

Reinsurance
Program

§§1301, 10104

Privacy
Study

§3026

§3026, 3403,
6301,9015

§§1333, 10104

§§1333, 10104

§§1301, 1302,
1311, 10104

§1301

Health
IT Policy
Committee

§1561

§§1311, 10104

§1001

§3011

§3013

§1001

Health
Care Choice
Compacts

NAIC
§§1333, 1341,
10104

Qualified
Health
Plans

§1411

§8002

§§3013, 10304

Value-Based
Insurance Design
& Coverage of
Preventive Health
Services

§1001

§4302

§3011

§3403

Medicare
Part A Trust
Fund

§§9001, 10901; HCERA §1401
§1333, 10104

Gold

§1311

§§3011, 3012

National
Health Disparities
Data Collection &
Reporting
System

National
Health Strategy
& Priorities
Office

§§1201, 1301, 1302

§1001

§3011

§3011

§3013

Public
Health Quality &
Efficiency Measures
Development
Program

Health
Care Quality
Website

§10407

States

Platinum

§§1401, 3001, 3403, 6301,
10105, 10320

Vital
Statistics
Agencies

§6703

§§1311,1331,
1333,1341, 10104,
10407

§1001

Health & Human
Services

§3011
§4302

§1331, 10104

§6703

§6703

§1411

§§3011, 4002, 4302

Silver

§1341, 10104

§1331, 10104

§1331, 10104

§4004

§4002

§3011

US
Preventive
Services
Task Force

Secretary

Website
“Transparency
in Government”
§1552

Public
Health
Service

§4001

§3011

§9008; HCERA §1404

Prevention
Website
§4004

§3011

Advisory
Group on
Prevention, Health
Promotion, and
Integrative and
Public Health

§4305

4

§3403, 10320

§9008; HCERA
§1404

§6703

§6703

§4305

§6301

§6301

Interagency
Pain Research
Coordinating
Committee

§1001, 10101

Annual Fee

§3012

§§1001,1201, 1301,
1302

Bronze

State
Surveyors

§§1201, 1301, 1302

§4001

§4001

§4001

§9008; HCERA §1404

Essential
Health Benefits
Package

§1311

Surgeon
General

§§1331, 10104

§§1311, 10104

§3012, 3013, 6031

22

Optional
Basic Health
Program

§1302

AHRQ

§10407

§4001

§4305

Prevention
& Public
Health Fund

1 4 1 2 , 35 0 9 , 5 10 1 ,
10104, 10221,
10334, 10413,
10501

GAO
§1331, 10104

§6703

§6703

§4001

Rules for
Insurance
Claims Appeals

Pharmaceutical
Companies

26

§4004

§4002

1 1 0 4 , 61 0 2 , 6 10 3

§§9009, 10904;
HCERA §1405

§10407

§6301

National
Prevention,
Health Promotion,
& Public Health
Council

§4002

Other New
Regulatory
Programs

§3006

1 2 0 1 , 27 0 4 , 2 70 5 , 2 7 06 ,
2707, 3023, 3024, 3113,
3140, 4204, 4206, 5304,
5509, 6112, 6114,
10212, 10221,
10315, 10323,
10326, 10504,
10607

§§1313, 1322

§2602

§2602

Elder
Justice
Coordinating
Council

Elder Abuse,
Neglect, &
Exploitation
Forensic Centers
§6703

§10407

§4001

§§1001, 1302, 1311, 1511, 1512,
1513, 6605, 10101, 10106

Home
Health Agencies

National
Diabetes Mortality
Statistics Education
Training Program

§§1001, 4003, 4004,
4102, 10407

§1302

§3012

§§9009, 10904;
HCERA
§1405

§4102

§4004

CDC

§4004

§§4305, 6301,
10409

National
Training Institute
for Federal and
State Surveyors
§6703

Comptroller
General

MedPAC

§10407

Other New
Demonstration
& Pilot Programs

§4102

Other New
Bureaucracies

§6301

IPAB

Advisory
Board on Elder
Abuse, Neglect,
& Exploitation
§6703

§3311

MultiDisciplinary
Panels on
Improving LongTerm Care
§6703

§6703

§3013

Labor
Department

§§1513, 10106

National
Diabetes
Report Card
Program
§10407

§6703

§6301

§3012

Black Lung
Benefits Act

Hours of Service
Determination
for Calculating
Employer Mandate
Penalty

§1312

§6301
§6301

PCORI
Expert
Advisory
Panels

§6301

§1556

§5605

§6301

§6703

PCORI
Trust Fund

§3012

NIH

§10409

§6301

§6703

Interagency
Working Group
on Health Care
Quality

National
Partnership on
Prevention &
Health
Promotion

§4004

§1334, 10104

Justice
Department

§10409

§10409

PCORI
Methodology
Committee

§§6301, 10602

§4004

PCORI

§1334, 10104

§4004

§3012

Cures
Acceleration
Network

§6301

§1312

§§1331, 10104

§4004

§6301

19

1 1 0 2 , 1 20 1, 2 0 0 6,3 1 3 7 , 3 20 1 , 3 3 0 1 ,
6 0 0 1 , 9 0 0 1 , 9 0 1 0 , 9 0 14 , 9 0 2 3 , 1 0 2 0 1 ,
1 0 3 1 7 , 1 0 3 2 3, 1 0 3 2 4, 1 0 5 0 2 , 1 0 6 0 1 ,
1 09 0 1 , 1 0 90 5 ; HCERA
1 1 0 1 , 1 10 3 ,
1106, 1203, 1406

§1333, 10104

National Oral
Health Public
Education
Campaign

§4003
§4003

§6301

National
Public Education
Campaign on
Prevention & Health
Promotion

§5605

Congress
§§1312, 1411, 3311, 5605, 8002

§§1331, 10104

§8002

Community
Preventive
Services Task
Force

BENEFICIARIES:
Mut ual of Omaha (NE);
Drug Cos; NJ Drug Cos;
AARP; Libby Mont anans;
Physician-Owned Hospit als;
Univ. of CT; Medigap Plans;
Longshoreman Healt h Plans;
Medicaid: HI, LA, MA, TN, VT;
Medicare: CT, FL, MI, MT, ND

§8002

§6703

§8002

PCORI Board
of Governors
Office of
Multi-State
Qualified
Health Plans

§6301

§6301

CLASS
Independence
Benefit Plan

Special
Interest
Provisions

§5605

Office
of Tax
Analysis

§8002

Cures
Acceleration
Network
Review Board
§10409

PCORI
Website

§§1513, 10106; HCERA §1003

§§1401, 1402, 1411, 1412 1414,
1421, 1501, 9004, 9005,
10105, 10901; HCERA
§§1401, 1402

§§1311, 1331, 4002,
8002, 10104

§8002

§8002

§6301

Personal
Care Attendants
Workforce
Advisory Panel
§8002

§5605

Congress
Members
& Personal Staff
Mandate:
Only Exchange
Coverage

§9002

CLASS
Independence
Fund Board of
Trustees

§8002

Treasury
Department

Commission
on Key
Indicators

Key
National
Indicator System
Implementation
Institute

§§3103, 10320

§3403, 10320

CLASS
Program

§8002

§1411
§8002

10323, 10333,
1 0 4 0 8 -1 0 , 1 0 4 1 3 ,
10501, 10503

§8002
§8002

§8002

Office of
Personnel
Management

§8002

§8002

Social
Security
Administration

59

1 0 0 2 , 10 0 3 , 1 31 1 , 1 3 22 ,
1 5 6 1 , 2 9 5 2 , 2 9 5 3 , 3 5 0 1 -6 ,
3508, 4101, 4108, 4201,
4202, 4304, 5102 , 5206,
5 2 0 8 , 5 3 0 1 -5 3 0 3 , 5 3 0 5 ,
5306, 5309 , 5313,
5 3 1 5 , 5 4 0 5 , 5 5 0 7 -8 ,
5604, 6703,
10301

§8002

CLASS
Independence
Fund

§3403, 10320

State
Protection &
Advocacy
Systems

IRS

Other New
Grant Programs

§5605

§§ 3012, 3024, 3403, 4001,
8002, 10320

Eligibility
Assessment
System

CLASS
Independence
Advisory
Council

Life
Independence
Accounts

§1411

§§1334, 10104

National Academy
of Sciences

§1414
§1411

§1312

Homeland
Security
Department

§5605

§5605
§5605

§8002

§9013

§§1401, 1412, 10105; HCERA §§1001, 1004

AGI: Adjusted Gross Income
AHRQ: Agency for Healthcare Research and Quality
CDC: Centers for Disease Control & Prevention
CHIP: Children’s Health Insurance Program
CLASS: Community Living Assistance Services & Supports
CMS: Centers for Medicare & Medicaid Services
CO-OP: Consumer Operated & Oriented Program
FFS: Fee-for-Service
FSA: Flexible Spending Arrangement
GAO: Government Accountability Office
HCERA: Health Care & Education Reconciliation Act
HHS: Health & Human Services Department

HSA: Health Savings Account
IPAB: Independent Payment Advisory Board
IRS: Internal Revenue Service
MA-PD: Medicare Advantage Prescription Drug
MedPAC: Medicare Payment Advisory Commission
MERD: Medical Early Risk Detection
EALORS: Executive Auxiliary Linked Office Regional Systems
MEWA: Multiple Employer Welfare Arrangement
NAIC: National Association of Insurance Commissioners
NIH: National Institutes of Health
PCORI: Patient-Centered Outcomes Research Institute
PPS: Prospective Payment System

§§1402, 1412; HCERA §1001

Patient Protection & Affordable Care Act, P.L. 111-148;
Health Care & Education Reconciliation Act, P.L. 111-152

Prepared by: Joint Economic Committee, Republican Staff
Congressman Kevin Brady, Senior House Republican
Senator Sam Brownback, Ranking Member

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