IWIF Wellness Symposium John M. Colmers, Secretary Maryland Department of Health and Mental Hygiene June 8, 2010

Launched on May 19, 2010

Patient Protection and Affordable Care Act Signed into law by President Obama on March 23, 2010 Reform will do what many states could not do on their own –Expand Medicaid across the board to childless adults –Require health insurance coverage –Establish subsidies –Eliminate medical underwriting 6

Patient Protection and Affordable Care Act (cont.) Offers numerous opportunities for states to address other parts of reform –Cost containment –Quality and delivery system reform –Realignment of programs funding uninsured Maryland’s many strengths, including our unique all-payer system and recent health expansions leave us well-positioned to implement reform 7

Implementation Requirements Significant changes in eligibility process and systems Changes to claims processing systems Increase in administrative infrastructure, e.g., call center, eligibility workers Must ensure adequate provider network Significant insurance market regulatory and policy changes needed While majority of action is needed in 2011 and 2012, some provisions have immediate effective dates 8

Implementation in Maryland Maryland Health Care Reform Coordinating Council was c reated through an Executive Order to advise the Administration on policies and procedures to implement federal health reform as efficiently and effectively as possible. The Coordinating Council will make policy recommendations and offer implementation strategies to keep Maryland among the leading states in expanding quality, affordable health care while reducing waste and controlling costs. 9

Coordinating Council Members The Honorable Anthony G. Brown Lt. Governor Council Co-Chair John M. Colmers Secretary, DHMH Council Co-Chair Carolyn Quattrocki Deputy Legislative Officer Governor’s Designee T. Eloise Foster Secretary, DBM Beth Sammis Acting Commissioner, MIA Douglas F. Gansler Maryland Attorney General Marilyn Moon Chair, MHCC Donald A. Young, M.D. Chair, HSCRC The Honorable Edward J. Kasemeyer Member, Maryland Senate The Honorable Thomas “Mac” Middleton Member, Maryland Senate The Honorable Peter Hammen Member, Maryland House of Delegates The Honorable James W. Hubbard Member, Maryland House of Delegates 10

Responsibilities The Coordinating Council will submit an interim report to the Governor in July and a final report by January 1, Report shall include: –Review of each section of the federal legislation and identification of affected State law and regulation –Comprehensive timeline, including key decision points –Financial model to estimate annual impact on State general funding budget; and –Approach for evaluation of options, including method for soliciting input from interested stakeholders 11

Operating Principles In developing recommendations, the Coordinating Council shall be guided by criteria to include: –Promotion of positive health outcomes; –Access, quality, and equity; –Workforce development; –Administrative efficiency; and –Containing rate of growth in cost of public and private sector health care financing 12

Initial Meeting Schedule Meeting 1: May 6, 2010, 1-4 Introductory; affirmed principles for Council; Began substantive review Meeting 2: June 10, 9-1 Meeting Goal – Council to get input on questions for draft interim report Meeting 3: July 1, 9-1 Meeting Goal – Council to provide feedback on initial draft interim report Meeting 4: July 19, 9-1 Meeting Goal – Review draft interim report, provide final input and make decisions for final interim report –July 23 – Submit Final Interim Report to Governor July – January Meetings and Workgroups to support development of final report 13

Process for Public Input Phase 1 – Assessment of Health Reform (May-mid July, for July Report) –Stakeholder comments to guide Interim Report Phase 2 – Discussion and Development of Recommendations (mid-July to end of October) –Active workgroups focused on key implementation issues Phase 3 – Review Draft Recommendations (mid-November- early December) –Public hearings about reform recommendations Phase 4 – Finalize Recommendations and issue report (early-December – January 1) 14

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