Groups predicted to benefit from expected health reforms

Responses predicting which groups might benefit from health reforms show mixed and somewhat contradictory results, says Don Hall, Medicaid consultant, principal of Delta Sigma, LLC.

Of those predicted to benefit most, state Medicaid plans are at the top (30.9%) and private Medicaid plans are at the bottom (4.5%).

The long-awaited America’s Health Future Act, introduced by Senate Finance Committee Chairman Max Baucus (D-Mont.) on September 16, provides rewards for states that provide the chronically ill in Medicaid health homes. It also aims to reward members for healthy choices.

Under virtually every scenario of the current proposed healthcare reforms, the number of Medicaid recipients would be increased, which would only mean more business for those plans, Hall says. Medicare Advantage plans are another story.

“Under every scenario that I see, Medicare Advantage would get some kind of premium reduction,” he says.

Employers took the number two spot (18.9%) for those who would most benefit, and the Baucus proposal is fairly supportive of small employers. It would provide eligible small businesses a tax credit for up to 35% of their contributions. Additionally, employers with fewer than 50 employees would not be required to offer health benefits. Small business would also have access to state insurance exchanges under the plan.

The results show that many in the industry aren’t sure how healthcare reform is going to affect them, Hall says.

“As people in Washington say, anyone who thinks they know what healthcare reform is going to look like doesn’t know what they’re talking about,” he says.

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