8:00 a.m. – 8:45 a.m.

Registration & Breakfast

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8:45 a.m. – 9:00 a.m.

Welcome Remarks & Program Overview

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9:00 a.m. – 10:00 a.m.

Session I:

 

The State of Health: A Legislator’s Perspective

Since the Patient Protection and Affordable Care Act (ACA) was enacted in 2010, it has led sweeping changes to the U.S. health care system. The law has touched almost every aspect of our health care system, from how coverage is obtained to how the health care services are provided. During this introductory session, participants will hear an overview of the Health Summit’s agenda from and share their thoughts about the most pressing health policy issues facing state legislatures and how their states and communities have fared with the ACA.

Summit Facilitator: Hon. Jeffrey Sánchez, Massachusetts State Representative; Chair, Joint Committee on Health Care Financing

• Mr. Thomas Betlach, Director, Arizona Health Care Cost Containment System, President, National Association of Medicaid Directors
PRESENTATION

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10:00 a.m. – 11:30 a.m.

Session II:

 

Where Are We Now? An Update on the Affordable Care Act

Under the ACA, millions of previously uninsured Americans have become eligible for health insurance. On June 2, 2015, HHS provided updated enrollment figures citing that as of March 31, 2015, 10.2 million people are covered by the Affordable Care Act. According to the Centers for Medicare & Medicaid Services, this is up from 6.3 million at the end of 2014. However, since the passage of the ACA, there have been numerous actions in federal courts to challenge the constitutionality of the legislation and key provisions. Most recently the U.S. Supreme Court ruled on the case King v. Burwell, upholding health insurance subsidies for people who purchased their insurance through a federal health exchange in states that did not set up their own exchanges. With the legality of the health care tax subsidies settled, policymakers must now look to the future and begin to think about the ongoing and impending policy issues that will affect the access and delivery of quality and affordable health care for all Americans. This session will provide participants with an update on the current state of health access and coverage in the United States and will examine its effect on state budgets and other policy areas.

Summit Facilitator: Hon. Luz Escamilla, Utah State Senator; Member, Senate Health and Human Services Committee

• Ms. MaryBeth Musumeci, Associate Director, Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation
PRESENTATION

• Ms. Sinsi Hernández-Cancio, Health Equity Director, Families USA
PRESENTATION

• Ms. Joy Johnson Wilson, Director, Health & Human Services Policy, National Conference of State Legislatures

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11:30 a.m. – 12:30 p.m.

Session III:

 

Addressing the Health Care Needs of Medically Disenfranchised Populations

The medically disenfranchised includes populations that come from diverse economic backgrounds and communities whose common feature includes a lack of regular and continuous source of primary health care. According to the National Association of Community Health Centers, there are 60 million Americans who do not have access to primary care because of shortages of such providers. As policymakers and providers seek new strategies for expanding access to primary care, one trend that is gaining traction is the use of telemedicine or “telehealth.” It has spread rapidly and is now becoming integrated into the ongoing operations of hospitals, specialty departments, home health agencies, private physician offices and consumer’s homes and workplaces. This session will provide participants with the opportunity to learn more about the gaps in access to primary care and the leadership role that policymakers can play in helping to close this gap.

Summit Facilitator: Hon. Gustavo Rivera, New York State Senator; Member, Senate Health Committee

• Mr. Joseph Gallegos, Western Region, Senior Vice President, National Association of Community Health Centers
PRESENTATION

• Mr. Mario Gutierrez, Executive Director, Center for Connected Health Policy

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12:30 p.m. – 1:45 p.m.

Luncheon Presentation

 

An Update on State Level Policy Regarding Biologics and Biosimilars

Biologics are very complex medical products whose active drugs are made by or from living organisms. Biosimilars are follow-on biologics that have been approved as subsequent versions of original biologics and made by different manufacturers. With the passage of the ACA, the U.S. Federal Drug Administration was given the authority to approve biosimilars. However, the substitution of generic drugs with branded drugs is regulated by individual states. This presentation will provide an update on the issues state legislators should be aware of surrounding state regulation of biosimilar substitution/interchangeability as well as an update of state regulatory actions to date.

Keynote Remarks: Hon. Mary K. Wakefield, Deputy Secretary, U.S. Department of Health and Human Services

Program Presentation: Dr. Philip Schneider, Member, Alliance for Safe Biologic Medicines
PRESENTATION

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1:45 p.m. – 2:00 p.m.

Break

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2:00 p.m. – 3:30 p.m.

Session IV:

 

A Look at the Future and Cost of Health Insurance Rates

The increased cost of health insurance is a reality in any discussion on health policy and health care delivery. Health insurance experts are predicting that health insurance premiums through the Affordable Care Act will rise more significantly next year than in the first two years for millions of Americans. The reasons for the rising premiums are complex, but the rise is partly attributed to carriers now knowing more about the health status and care patterns of their customers. This session will discuss the effect these increasing health costs will have on individual consumers, employers and the quality of health care delivery.

Summit Facilitator: Hon. Jeffrey Sanchez, Massachusetts State Representative; Chair, Joint Committee on Health Care Financing

• Mr. Michael Lujan, Co-Founder and Chief Strategy Officer Limelight Health, President, California Association of Health Underwriters

• Mr. Louis Gutierrez, Executive Director, Massachusetts Commonwealth Health Insurance Connector Authority
PRESENTATION

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3:30 p.m. – 4:00 p.m.

Summit Facilitators Wrap Up & Adjourn for the Day

This facilitated session will provide policymakers with the opportunity to engage in a strategic discussion about state policy opportunities and potential roles policymakers can play on key health policy issues.

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6:00 p.m. – 8:00 p.m.

Opening Reception & Celebration

In Honor of The Honorable Luz Weinberg and The Honorable Juan C. Zapata

7:30 a.m. – 8:30 a.m.

Registration & Breakfast

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8:30 a.m. – 8:45 a.m.

Overview of the Day: A Legislator’s Perspective

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8:45 a.m. – 10:15 a.m.

Session V:

 

The Future of Prescription Drug Prices

The issue of drug cost is personal to many Americans. According to a recent poll by the Kaiser Family Foundation, “nearly three-quarters of the public think that the cost of prescription drugs is unreasonable.” The factors that dictate drug prices are complex and include the time and cost it takes to develop a medicine, test it, get it approved by regulators, and ultimately bring it to patients. As a growing national debate ensues on the current and future cost of prescription drugs, it is critical that policymakers be well informed on this complex health policy issue. This session will explore the debate on pricing guide lines and the role the public, insurers and federal, state and local governments play in this discussion.

Summit Facilitator: Hon. Jeffrey Sanchez, Massachusetts State Representative; Chair, Joint Committee on Health Care Financing

• Ms. Tara Ryan, Vice President of Policy, PhRMA
PRESENTATION

• Mr. Jesse Fry, Policy Analyst, The AIDS Institute
PRESENTATION

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10:15 a.m. – 11:45 a.m.

Session VI:

 

A Risk We All Face: The Need for Long-Term Care

As people live longer and baby boomers grow older, the need for Long-Term Services and Supports (LTSS) will increase significantly, both in numbers and as a percentage of the U.S. population. Experts say that in just a few short years, as baby boomers retire, long-term care of the elderly will become a national crisis. Today, more than 40 million people in the United States are 65 and older, a number expected to more than double within the next twenty years; thus the number of Americans needing LTSS is expected to double as well over the next thirty years. This session will examine the impending long-term care crisis and help policymakers understand the cost and financing of these services from a personal, local, state, and federal level perspectives.

Summit Facilitator: Hon. René García, Florida State Senator; Chair, Appropriations Subcommittee on Health and Human Services; Board Member, NALEO Educational Fund

• Ms. Olivia Mastry, JD., MPH, Founder, Collective Action Lab
PRESENTATION

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11:45 a.m. – 12:00 p.m.

Break

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12:00 p.m. – 1:00 p.m.

Luncheon

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1:00 p.m. – 1:15 p.m.

Break

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1:15 p.m. – 2:45 p.m.

Session VII:

 

The Move from Fee-for-Service to Value-Based Reimbursement: Exploring the Transition

The U.S. Department of Health and Human Services (HHS) announced the goal of transitioning 85 percent of Medicare fee-for-service reimbursements into fee-for-value payments by 2016. Instead of providers being paid by the number of visits and tests they order (fee-for-service), their payments will now be based on the value of care they deliver (value-based care). By the end of 2014, the Centers for Medicare and Medicaid Services estimated that 20 percent of Medicare reimbursements had shifted to value-based payments. This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments. To be able to move this transition forward beyond Medicare, HHS has created a Health Care Payment Learning and Action Network. Through this Network, the agency will work with private payers, employers, consumers, providers, states and state Medicaid programs, and other stakeholders to expand alternative payment models into their programs. This session will provide an overview of the transition and the important role patients, employers, private insurers and policymakers, whose states budgets will be deeply affected by healthcare costs, will play.

Summit Facilitator: Hon. Luz Escamilla, Utah State Senator; Member, Senate Health and Human Services Committee

• Ms. Sandra Lynne Fryhofer, Director of Delivery System Reform, Office of Health Reform, U.S. Department of Health and Human Services
PRESENTATION

• Dr. Tomas Garcia, III, President, Texas Medical Association

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2:45 p.m. – 3:15 p.m.

Facilitated Wrap-Up Discussion, Evaluations & Closing Remarks

This facilitated session will provide policymakers with the opportunity to engage in a strategic discussion about state policy opportunities and potential roles policymakers can play on key health policy issues.