An overview of House and Senate legislation for federal health reform, with sections relating to physicians and the legislations' impact on Massachusetts. Presented by Massachusetts Medical Society President Mairo E. Motta, M.D., at the Interim Meeting of the MMS House of Delegates.

1. Health Care Reform 2009 The Great American Debate and the Massachusetts Experiment Mario Motta, MD President Alice Coombs, MD President-Elect

2. Federal Health Care Reform

4. Expanding Coverage Senate House Covers 31 million additional people (94% covered) Covers 36 million additional people (96% covered) Cost: $849 billion by 2019 Cost: $894 billion by 2019 Reduces deficit by $130 billion by 2019 Reduces deficit by $109 billion by 2019 State exchanges Federal exchange Subsidies up to 400% of poverty Subsidies up to 400% of poverty (Higher premium subsidy than Senate bill) No mandate But employers surcharged if employees get coverage through the Exchange (> 50 employees) Employer mandate

5. Insurance Reforms Senate House Prohibit exclusions for pre-existing conditions Prohibit exclusions for pre-existing conditions Guarantee issue and renewal (Bans recission) Guarantee issue and renewal (Bans recission) No gender discrimination; no lifetime caps No gender discrimination; no lifetime caps Report medical loss ratios Report medical loss ratios House limits non-medical expenses; rebates excess to consumers

16. www.massmed.org/PaymentReform www.massmed.org/HealthCareReform blog.massmed.org www.facebook.com/massmed www.twitter.com/massmedical