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§§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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