• On March 21, 2010, the House of Representatives passed the Senate version of the health care

reform bill and a health care reconciliation bill that makes changes to the Senate bill.

• President Obama is expected to sign the Senate bill into law.

• Now, the House’s health care reconciliation bill must go to the Senate for approval.

– If the Senate passes the health care reconciliation bill without any changes, then the Senate’s

health care reformbill and the health care reconciliation bill will go to the President for his signature.

– If the Senate has changes to the health care reconciliation bill, then it must go back to the House

for approval again.

• The health care reform bill and health care reconciliation bill will be sent to the President to sign into law

after being approved and passed by both the House and Senate.

The following are highlights of key components of the health care reform and health care reconciliation bills.

For complete details on the bills, please go to http://www.rules.house.gov/bills.aspx

• Provides greater coverage through state-based exchanges for individuals to purchase health coverage

through an Internet-based market.

• Includes both individual responsibility to have coverage and employer responsibility to provide coverage.

• Phased-in provisions to close the “doughnut-hole” in Medicare Part D (prescription coverage).

• Expands eligibility for Medicaid up to 133 percent of federal poverty level (approx. $29,000 for a family of four).

This will not affect New York state because our eligibility requirements are already above that level.

• Insurance market reforms that bring 45 other states in line with New York state making it illegal for health

plans to deny people coverage based on their health status or gender and prohibits lifetime and annual limits

on covered services.

• Provisions are included to ensure affordability for individuals through government subsidies on premiums,

and tax credits to small businesses for providing coverage.

• Quality provisions for new reimbursement models that advance a health care system based on quality

outcomes, not quantity of services provided. Adoption of evidence-based medicine and best practice

standards of care.

• The provisions in the Senate bill and the health care reconciliation bill are expected to cost approximately

$940 billion over 10 years, while reducing the deficit by $138 billion over the same time period.

• The contributing factors to reduce the deficit include reductions to Medicare Advantage plans, new fees on

the health insurance industry, taxes on high-cost “Cadillac” plans, an excise tax on brand name pharmaceuticals

and medical devices, and additional taxes on unearned income for high-earning individuals.

Broadly speaking, most of the facets of the reform proposal coming out of Washington are consistent with the

transformation strategy our company has been following for the past several years. Through a wide range of

initiatives, we have been focusing on achieving many of the same goals included in the national health care

reform bill to help ensure all Western New Yorkers and all Americans have access to affordable, high-quality

coverage, including:

• Rewarding providers for delivering optimal care by linking payments to uniform performance measures

• Introducing a Patient-Centered Medical Home project which includes 140 physicians and 50,000 members

in an effort to enhance access to care and improve clinical outcomes

• Recognizing the importance of prevention and wellness by becoming the first health plan in the region

to offer $0 copay for preventive care

• Partnering with employers such as the Town of Amherst to help them take greater control over their

health care costs by engaging employees in healthy lifestyle behaviors

• Accelerating the adoption and use of health information and electronic medical records

Independent Health firmly believes that our transformation efforts will continue to give us a leg up as we

implement the short and long-term changes coming out of Washington. There is still much work to be done

as we continue to provide the visionary leadership and cutting-edge innovation that our members, employers,

physicians, providers and the entire community have grown to expect from Independent Health.

The health reform legislation helps ensure that more Americans have access to health insurance coverage and

it includes subsidies and support to help individuals and small business afford coverage. However, to sustain this

expansion of coverage, efforts will need to focus on bending the medical trend and reducing costs.

Independent Health recognizes that improving the quality of care and bending the medical trend is a collective

responsibility. It requires wide-ranging partnerships and efforts to increase wellness, emphasize prevention,

invest in technology, and increase efficiency in our health care system. We remain committed to working with

our key stakeholders to improve access to quality health care and reverse the overwhelming and unsustainable

trend of rising health care costs.

©2010 Independent Health Association, Inc.