1. State and Federal Legislative Landscape
William J. Castner, Jr.
Senior Vice President, Corporate & Regulatory Affairs
Horizon Blue Cross Blue Shield of New Jersey

2. Disclosure Declaration
Mr. Castner does not have a vested interest in or affiliation with a corporate organization offering financial support or grant monies for this CE activity.
Mr. Castner does not have an affiliation with an organization that has a specific interest in the therapeutic areas under discussion.

3. New Jersey Update
Horizon Blue Cross Blue Shield of New Jersey defeated $300M reserve raid this summer
Gubernatorial election on November 7, 2017
All 120 legislative seats up for election
Lame duck legislative session
Transition through January 16, 2018

4. Looking Ahead in the State House
Opioids
Out-of-network reform
Stabilizing the individual market
Protecting Medicaid
Public sector health benefits
Women’s health issues
Driving down health care costs
Continuing toward value-based care

5. Legislation in the Senate
Washington, D.C.
Despite a revived version of the American Health Care Act (AHCA) passing the House, health insurance reform stalled in Senate
Potential Significant Changes in the Senate Need Support from Both Moderates and Conservatives
Three Republican Votes Sink the
Legislation in the Senate
Priorities: Preserve patient protections and boost subsidies for older individuals
Priorities: Repeal as many ACA requirements as possible
Moderates
Health Affairs blog:
Medscape:
Conservatives
House and Senate Republicans must come to an agreement if significant changes are made to AHCA in the Senate
Democratic Party (D): 46 seats
Republican Party (R): 52 seats
Independent (D-caucusing): 2 seats

6. Health Care Policy Discussions
White House
Continuing to maintain that repealing the Affordable Care Act is a priority
Pressuring Senate leadership to abandon filibuster and vote again on repeal and replace
Using cost-sharing reduction funding as leverage
Congress
Bipartisan discussions on stabilizing the market and greater state flexibility
Conservatives warning against insurance company “bailouts”
Medscape:
Chicago Tribune:
Centers for Medicare & Medicaid Services (CMS) / Health and Human Services
CMS regulations aiming to stabilize the individual marketplace have been finalized
Secretary Price has encouraged states to take an active role in experimenting with market solutions

7. Rising Premiums Nationally

8. Rising Premiums Nationally

9. Areas of Reform Under Discussion
Cost-sharing reductions
State flexibility
Health insurance taxes
Medicaid funding

10. Forecast