Washington Update Nathan Baugh Director Government Relations 202

Washington Update Nathan Baugh Director, Government Relations (202) 544 -1880 Baughn@capitolassociates. com www. narhc. org

RHC Rules That Make No Sense Statute ~ SSA Regulation ~ CFR Guidance ~ Appendix G Statutory changes @ Congressional level Regulatory changes @ CMS Guidance changes also @ CMS Guidance “fixes” coming (what does that mean? ) NARHC seeking statutory fixes this summer 2 potential opportunities in 2018 CR in Sep CR in lame duck session

Healthcare IS Complicated

Healthcare Spending 2006 -2017 8. 0% 6. 0% Annual % Growth 4. 0% 2. 0% 0. 0% 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 -2. 0% -4. 0% Year CPI-U (Consumer Price Index for Urban Consumers) National Medical Expenses National GDP 2006 3. 2% 6. 5% 2. 7% National Medical Expenses 2007 2008 2009 2. 8% 3. 8% -0. 4% 6. 5% 4. 0% 1. 8% -0. 3% -2. 8% 2010 1. 6% 4. 1% 2. 5% 2011 3. 2% 3. 5% 1. 6% 2012 2. 1% 4. 0% 2. 2% National GDP 2013 1. 5% 2. 9% 1. 7% 2014 1. 6% 5. 1% 2. 6% 2015 0. 1% 5. 8% 2. 9% 2016 1. 3% 4. 3% 1. 5% Data according to Kaiser Family Foundation, and the Center for Medicare and Medicaid Services https: //www. cms. gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/National. Health. Expend. Data/Downloads/NHE-Presentation-Slides. pdf https: //www. kff. org/interactive/premiums-and-worker-contributions/#/? coverage. Type=worker_contribution&start. Year=2005 2017 2. 1% 4. 6% 2. 3% Average 1. 9% 4. 7% 1. 6%

Politics Surrounding Health Care Unclear Is The the Affordable Care Act repealed? main national “problem” surrounding health care remains Healthcare costs continue to rise at presumably an unsustainable rate… Will this trend force Washington DC to revisit big and fundamental healthcare reform efforts? Can we continue to tweak the current system around the edges and bring healthcare costs under control?

Questions?

Nathan Baugh Director, Government Relations (202) 543 -0348 Baughn@capitolassociates. com www. narhc. org