2009 Congressional Health Care Reform Legislation

Molina Supports the Following Policies

Molina Supports Expansion of Medicaid - both the Senate and House draft bills include expansion of Medicaid eligibility up to 133% of Federal Poverty Level (FPL).

Molina Supports Medicaid Drug Rebates - both House and Senate draft bills expand the Medicaid Prescription Drug Rebate to Medicaid beneficiaries in managed care organizations.

Molina Supports Medicaid Provider Tax Extension - the House bill includes a one-year extension of the Medicaid Provider tax until 2010.

Molina Supports CHIP Extension - the Senate bill includes an extension of the Children’s Health Insurance Program until 2019.

Molina Supports Medicare Advantage Special Needs Plans Extension - the House (2012) and Senate (2013) bills include extension of Medicare Advantage SNP authorization.

Molina Supports the Individual Mandate - the Senate bill includes a mandate for every American to obtain health insurance coverage or incur a tax penalty.

Molina Supports Insurance Market Reforms - both the Senate and House bills include insurance market reforms including elimination of pre-existing condition exclusions, rating rules and out-of-pocket expense limits.

Molina Supports Caps for Out-of-Network Payments for Medicaid Managed Care - neither bill addresses rationalization of Medicaid Managed Care out-of-networkpayment policies beyond emergency services.

Molina Supports Providing More Guidance to CMS related to Actuarial Soundness - Molina has crafted language which provides clarity on how CMS should review and analyze rates developed for Medicaid Managed Care by states, and we will work to have this language added to any conference report that is written at the successful conclusion of healthcare reform.

Molina Supports Carving-out Medicaid from the Health Insurance Exchange - the House bill prevents Medicaid enrollees from accessing the health insurance Exchange for individual and small group insurance plans.

Molina Opposes the Following Policies

Molina Opposes a Public Insurance Option - the House and Senate HELP bills include the creation of a public insurance option created and administered by the Federal Government.

Molina Opposes the Insurance Industry Tax - the Senate bill includes an annual $6.7 billion fee on insurance providers assessed according to market share of net premiums.

Molina Opposes inclusion of CHIP Enrollees in the Health Insurance Exchange - the House bill ends CHIP in 2013 and requires those eligible for the program to purchase insurance through the Exchange.

Molina Opposes inclusion of Medicaid Enrollees in the Health Insurance Exchange - the Senate Finance bill permits Medicaid-eligible beneficiaries between 100% and 133% of FPL to purchase insurance through the Exchange with states being required to provide additional wrap-around benefits.

Molina opposes Medical Cost Ratio Requirements - the House bill requires Medicaid Managed Care organizations to have a minimum medical cost ratio of at least 85%.

Molina Opposes Medicare Advantage Cuts - both the Senate and House bills cut payments to Medicare Advantage plans.

Advantage Special Needs Plans - The Senate bill includes a provision for competitive bidding for Medicare Advantage Plans including SNPs.