Obamacare’s rocky start and uncertain future
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Event Summary

The Obama administration recently announced that by the end of the Affordable Care Act's (ACA's) open enrollment period, more than 8 million people had signed up for health insurance on the exchanges. On Friday, AEI convened a group of health policy experts with a wide range of perspectives on the ACA to assess the law's past performance and to offer input on its future prospects.

AEI's own James Capretta began the discussion by pointing out that while the administration has celebrated the law's ability to meet certain expectations, implementation has in fact been marred by many failures. Timothy Jost of Washington and Lee University in part agreed with Capretta but defended the ACA in arguing that the high premiums associated with essential health benefits can be attributed to increased actuarial values. Mark Pauly of the Wharton School of the University of Pennsylvania argued that the ACA is neither a government takeover of the health insurance industry nor a total transformation; in time, it will fall into bureaucratic backwater.

The second panel addressed state, employer, and health sector reactions to the ACA. Jeff Goldsmith of the University of Virginia pointed to a wave of layoffs and other issues as evidence of the uncertainty caused by the ACA's complicated implementation. Tracy Watts of Mercer presented her company's survey results, which show that, for example, more than half of employers do not see the individual mandate as the reason many previously uninsured employees enrolled in 2014.

Alan Weil of the National Academy for State Health Policy, however, pointed to one particular point of optimism: outside of coverage maps, party divisions on health reform issues are much less apparent. In his luncheon address, Robert Laszewski of Health Policy and Strategy Associates concluded that while the ACA does require significant reform, once the legislation passed and cleared the Supreme Court, repealing and replacing it became unrealistic.
--Neil McCray

Event Description

The Affordable Care Act (ACA) gave Americans six months to enroll in health insurance. Now that open enrollment has ended, we can assess the law's first-year performance and look ahead to 2015 and beyond.

Are Americans satisfied with the health plans offered on the exchanges? Will taxpayers have to pay large sums to insurers to cover first-year losses, and will premiums rise markedly over the next year? How did employers and states respond to the challenges and opportunities presented by the ACA in the first year, and what can be expected going forward? During this event, experts with many different views on the ACA will offer their predictions for the future.   

If you are unable to attend, we welcome you to watch the event live on this page. Full video will be posted within 24 hours.

Agenda

9:00 AM
Registration and Breakfast

9:15 AM
Panel I: The changing policies of the Affordable Care Act
Panelists:
James C. Capretta, Ethics and Public Policy Center and AEI
Timothy Jost, Washington and Lee University
Mark Pauly, Wharton School of the University of Pennsylvania

Moderator:   
Joseph Antos, AEI

10:40 AM
Panel II: Responding to the Affordable Care Act: States, employers, and the health sector
Panelists:
Jeff Goldsmith, University of Virginia
Tracy Watts, Mercer
Alan Weil, National Academy for State Health Policy

Moderator:   
Robert B. Helms, AEI

12:00 PM
Luncheon Address
Introduction:
James C. Capretta, Ethics and Public Policy Center and AEI

Speaker:
Robert Laszewski, Health Policy and Strategy Associates

1:15 PM
Adjournment

Event Contact Information

For more information, please contact Neil McCray at [email protected], 202.862.5826.

Media Contact Information

For media inquiries, please contact [email protected], 202.862.5829.

Speaker Biographies

Joseph Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at AEI. He also is a member of the Panel of Health Advisers for the Congressional Budget Office and recently completed two terms as a commissioner of the Maryland Health Services Cost Review Commission. His research focuses on the economics of health policy, including Medicare and broader health system reform, health care financing and the budget, health insurance regulation, and the uninsured.

James C. Capretta has spent more than two decades studying American health care policy. As an associate director at the White House's Office of Management and Budget from 2001 to 2004, he was responsible for all health care, Social Security, and welfare issues. Earlier, he served as a senior health policy analyst on the US Senate Budget Committee and the US House of Representatives Committee on Ways & Means. Capretta is also concurrently a senior fellow at the Ethics and Public Policy Center. At AEI, he is researching how to replace the Patient Protection and Affordable Care Act (best known as Obamacare) with a less expensive reform plan to provide effective and secure health insurance to working-age Americans and their families.

Jeff Goldsmith is president of Health Futures Inc. and an associate professor of public health sciences at the University of Virginia. He was a lecturer on health services management and policy at the University of Chicago Booth School of Business and has also lectured at the Wharton School of the University of Pennsylvania, Johns Hopkins University, Washington University, and the University of California, Berkeley. His interests include biotechnology, health policy, international health systems, and the future of health services. From 1982 to 1994, Goldsmith served as national adviser for health care for Ernst & Young and provided strategy consultation to a wide variety of health care systems, health plans, and supply and technology firms. Before 1982, he was director of planning and government affairs at the University of Chicago Medical Center and special assistant to the dean of the Pritzker School of Medicine, University of Chicago. From 1973 to 1975, Goldsmith worked for the State of Illinois as a fiscal and policy analyst in the office of the governor and as special assistant to the state budget director.

Robert B. Helms is a resident scholar at AEI. He has served as a member of the Medicaid Commission as well as assistant secretary for planning and evaluation and deputy assistant secretary for health policy at the Department of Health and Human Services. He currently participates in the Health Policy Consensus Group, an informal task force that is developing consumer-driven health reforms. He is the author or editor of several AEI Press books on health policy, including “Medicare in the Twenty-First Century: Seeking Fair and Efficient Reform” (1999) and “Competitive Strategies in the Pharmaceutical Industry” (1996).

Timothy Jost holds the Robert L. Willett Family Professorship of Law at the Washington and Lee University School of Law. He has written numerous articles and book chapters on health care regulation and comparative health law and policy and has lectured on health law topics throughout the world. He is a coauthor of the casebook “Health Law: Cases, Materials and Problems” (West Publishing), used widely throughout the US in health law courses, and has written a treatise and hornbook by the same name. He is also the author of “Health Care Coverage Determinations: An International Comparative Study” (Open University Press, 2004), “Disentitlement? The Threats Facing our Public Health Care Programs and a Rights-Based Response” (Oxford University Press, 2003), “Readings in Comparative Health Law and Bioethics” (San Val Publishers, 2001), and “Health Care at Risk: A Critique of the Consumer-Driven Movement” (Duke University Press, 2007).

Robert Laszewski is president of Health Policy and Strategy Associates Inc. (HPSA), a policy and marketplace consulting firm specializing in assisting its clients through significant health policy and market change. He was named the Washington Post's 2013 Wonkblog Pundit of the Year for "one of the most accurate and public accounts" detailing the first few months of the Affordable Care Act rollout. Before forming HPSA in 1992, Laszewski was chief operating officer of a health and group benefits insurer. He is very active in the purchase and divestiture of health care and insurance businesses and has been involved in a number of such transactions in recent years. Laszewski has participated extensively in the nation's health care debate, especially on health insurance reform and the impact it will have on existing health insurance programs, the insurance industry, and the evolving role between payers and providers. He has also participated globally, having chaired two international meetings recently in Washington, DC, on the issue of international prescription drug pricing and the use of medical technology in Europe compared to the US. While in the insurance industry, he participated in a number of Health Insurance Association task forces including the board task force on cost containment and the working group on the ethics of genetic testing and insurance, and served as chairman of the Provider Relations Committee. Laszewski was a founding board member of the bipartisan Alliance for Health Reform and a member of the Board of Overseers of the C. Everett Koop Foundation at Dartmouth College and the Geisel School of Medicine at Dartmouth College.

Mark Pauly is Bendheim Professor in the Department of Health Care Systems at the Wharton School of the University of Pennsylvania. He is a professor of health care systems, insurance and risk management, and business and public policy at the Wharton School and a professor of economics in the School of Arts and Sciences at the University of Pennsylvania. Pauly is a former commissioner on the Physician Payment Review Commission and an active member of the Institute of Medicine. Pauly is a coeditor-in-chief of the International Journal of Health Care Finance and Economics and an associate editor of the Journal of Risk and Uncertainty. He has served on Institute of Medicine panels concerning public accountability for health insurers under Medicare and the improvement of the financing of vaccines. He is a former member of the advisory committee to the Agency for Health Care Research and Quality and, most recently, a member of the Medicare Technical Advisory Panel.

Tracy Watts is a partner at Mercer Human Resource Consulting (Washington, DC). A consultant with Mercer for more than 20 years, she leads the company’s health care and group benefits consulting segment activity for the Mid-Atlantic, Southeast, and Southwest US. She also leads Mercer’s health care reform consulting segment resources. Watts specializes in health care cost management; assisting employers in the design, evaluation, and ongoing management of health; and group benefit plans for active and retired employees. She is a Mercer spokesperson for both health care reform and the National Survey of Employer-Sponsored Health Plans, a Mercer survey of more than 3,000 employers across the US. Watts is a member of the National Business Group on Health’s National Leadership Committee on Consumerism and Engagement and a Mercer representative to the Council on Employee Benefits. Before joining Mercer in 1987, she worked in the benefits department of Diamond Shamrock Corporation in Dallas.

Alan Weil has been the executive director of the National Academy for State Health Policy (NASHP) since September 2004. Before joining NASHP, he served as director of the Urban Institute's Assessing the New Federalism project. He previously held a cabinet position as executive director of the Colorado Department of Health Care Policy and Financing, was health policy adviser to Colorado Governor Roy Romer, and was assistant general counsel in the Massachusetts Department of Medical Security. He is on the editorial board of the journal Health Affairs and is a member of the Institute of Medicine's Board on Health Care Services, the Commonwealth Fund's Commission on a High Performance Health System, and the Kaiser Commission on Medicaid and the Uninsured. He is a member of the board of trustees of the Consumer Health Foundation in Washington, DC, and the board of directors of the National Public Health and Hospitals Institute.

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