1. The New Health Reform Law and Private Insurance The Alliance for Health Reform Scott Keefer Americas Health Insurance Plans April 30, 2010

2. Health Plans and Implementation Implementation Efforts UnderwayNear Term Market ReformsLong Term Market Reforms

3. Implementation: Plan Efforts Underway Developing Transparency Standards with the NAIC Commitment to Covering Children with Pre-existing Conditions Preventing Gaps in Dependent Coverage Reforms Administrative Simplification Portal Demos (OH/NJ)

4. Near Term Reforms Impacting Plans Note: All near term reforms implemented by Jan 1, 2011 MLR Premium Rate Review Rescission/External Review Regulatory High Risk Pool Dependent Coverage Coverage for Children with Preexisting Conditions Small Business Tax Credits Access First Dollar Preventive Coverage Annual Limits (Restricted) Prohibition on Lifetime Limits Benefits Impact on Costs and Premiums; Provider Capacity?

5. Long Term Reforms Impacting Plans Key Goals : A Balanced Pool and Sustainability Market Reforms & Coverage Requirement Linkage: The All Important 1 st year Exchanges: Flexibility and Variation; Impact on ESI? Take Up and Getting Everyone In: Premium Credits and Medicaid Expansion Delivery Reforms: The Will to Change, Multi-Stakeholder Support, and Capacity Note: All long term reforms implemented by Jan 1, 2014

6. Driving Value in Delivery Reform Sustainability Requires a Commitment Equal to Access Improvements (learning the lessons of Massachusetts) PPACAs Cost Containment: End Point or a Foundation to Build Upon? Key Improvements: Transparency, A Strong Multi-Stakeholder Approach & System- Wide Focus Ensuring Affordability and Stability = Sustainability Over Long Run