Health Policy Task Force: Moving Forward on Health Care Reform: With or Without the Affordable Care Act
CSG Health Policy Task Force
Moving Forward on Health Care Reform: With or Without the Affordable Care Act
May 18, 2012
Reform, whether mandated by the Affordable Care Act or not, is needed to address citizens' demands for quality health care services. Medicaid, state employee health care and now, health insurance exchanges are potential policy levers to increase quality, improve states' health outcomes and hold the line on costs. This session highlighted replicable initiatives undertaken by states to build an improved health care system responsive to today's fiscal policy context.
- Capitol Ideas Today: Legislators Need to be Prepared for Changes in Health Care
- Report to CSG Executive Committee
The Health Policy Task Force heard presentations from three speakers related to health care reform and the future decision points facing states, no matter the resolution of the pending Affordable Care Act case before the U.S. Supreme Court.
"Health Insurance Exchange Design: Maximizing Information for Consumer Decision-Making"
Robert Krughoff, President, Consumers' CHECKBOOK
Robert Krughoff, executive director of Checkbook, demonstrated the broad extent of data available to state health insurance exchanges on the cost and quality of various health insurance plans. His non-profit organization provides a digital comparison of health insurance plans to federal employees that includes useful information to consumers such as probable out of pocket costs in a “good” year and in a “bad” year, the emphasis of plans on prevention, and quality ratings of physicians in plan networks. This data variety is more extensive than the data provided to consumers in the Massachusetts Connector and other exchanges under development.
"What If: Thinking Through State Health Insurance Decision Points Following the Supreme Court Decision on ACA"
Joan Gardner, Executive Director of State Services, Blue Cross Blue Shield Association
Also thinking about the future was Joan Gardner, executive director of state services for Blue Cross Blue Shield. When the U.S. Supreme Court decides the constitutionality of the Affordable Care Act in June, she said, state policymakers are going to have to be quick on their feet.
For instance, if the act is upheld, states will have to be ready to begin open enrollment in health care exchanges in the fall of 2013 and be ready to implement the system on Jan. 1, 2014. If states aren’t poised to act quickly, they will cede authority to the federal government, who will run state health exchanges if states elect not to do so themselves. If the ACA is overturned, states also face decisions around whether to preserve health insurance reforms that have already been put in place and how to proceed in the future.
"Primary Care: Alternative Paths for 21st Century Primary Care"
Dr. William Rowley, Senior Fellow, Institute for Alternative Futures
Even without extension of coverage under the Affordable Care Act, today’s health care system is challenged to provide adequate primary care to insured individuals. Dr. William Rowley, a senior fellow with the Institute of Alternative Futures, predicted the shortage of primary care will be exacerbated if the Affordable Care Act stands. Even though more medical schools are opening up, more people are going into primary care and the number of physician’s assistants and nurse practitioners have boomed, Rowley pointed out that more innovative ways of practicing medicine are necessary. He also spoke to the necessity of efforts to improve population health – public health policies aimed at environmental and lifestyle changes that prevent the need for medical intervention at all.
"Associates in Action: Astellas Science WoRx Prorgram"
Adam Miller, Director, State Health Policy, State Government Affairs, Astellas Pharma US, Inc.
Adam Miller, from Astellas Pharma U.S., presented the Associates in Action portion of the task force program. He shared information on “Science WoRx,” a program designed to help science teachers inspire the next generation of scientists. The program features a hands-on education and mentoring program, an online resource portal and online networking communities.
Speakers and Presentations:
Gardner is the executive director of state Services at the Blue Cross Blue Shield Association. The Association regulates the Blue brand, administers licenses, and helps coordinate national programs to the Blue Cross and Blue Shield companies so they may provide local leadership and solutions to promote safe, high quality and affordable care. Ms. Gardner previously held a position as vice president, Government Affairs Counsel at Blue Cross Blue Shield of Virginia. She has a law degree from Washington and Lee University and a Bachelor’s Degree from the University of Arkansas at Fayetteville.
Robert M. Krughoff
Robert M. Krughoff is founder and president of Center for the Study of Services/Consumers' CHECKBOOK, an independent, nonprofit consumer organization. The checkbook.org website and various CHECKBOOK publications are designed to help consumers choose high-quality, reasonably priced health plans, doctors, hospitals, and other services. CHECKBOOK has produced its Guide to Health Plans for Federal Employees for 33 years and has developed model health plan comparison tools for use by employers and state Exchanges. Under contract to government and private organizations, it conducts many large-scale surveys in which consumers evaluate their physicians, hospitals, and health plans. Krughoff served as director of the Office of Research and Evaluation Planning in the U.S. Department of Health, Education and Welfare (now HHS) for four years and is a member of various health policy and consumer boards. He is a graduate of Amherst College and the University of Chicago Law School.
Adam Miller currently serves as director, state health policy, state government affairs for Astellas Pharma US, Inc. Prior to joining Astellas State Government Affairs, Adam worked in multiple capacities within the sales and marketing organization for both Astellas and Ortho-McNeil Pharmaceuticals, where he received multiple honors for his performance.
From 1999–2005, Miller was twice elected to the Mount Pleasant Michigan City Commission, and the City Commission elected him twice to serve as the city’s mayor, the youngest mayor in city history. Adam is a graduate of Central Michigan University, earning both a Master of Public Administration and a Bachelor of Science in the Geographic Sciences. Adam is currently pursuing his Doctor of Health Administration with a research focus on pharmaceutical economics, ethics in health care and international public health.
Dr. William Rowley
Dr. William Rowley is a senior fellow with the Institute for Alternative Futures, a leader in the creation of preferred futures. Rowley is a subject matter expert and frequent keynote speaker on possible futures for a full range of health care issues. He has analyzed trends and developed forecasts and scenarios for specific diseases, advances in biotechnology, the evolution of health systems, and the future of various health professions. Dr. Rowley is a vascular surgeon who also has extensive leadership experience including being chief operating officer of one academic medical center and chief executive officer of two others. Dr. Rowley received a Bachelor’s degree in psychology and a Doctor of Medicine degree at the University of Minnesota. He achieved the rank of Rear Admiral in the United States Navy.