Health Care Reform: The Journey Continues

Key Points of Consideration for Small Group Employers and Individual Consumers and How Aetna Can Help (5:41)


So, looking at small group and individual outlook on slide 21 -- moving ahead to 21 -- the individual and small group markets are going to go through some very significant change. And we also know that the individual side of the exchanges - it's probably going to grow a lot faster than the small group side. And that's no surprise.

If you think about the subsidies that we described for individual and how, you know, how significant they are, compare them against the subsidies that are available for small group to shop on the SHOP exchanges. There is a subsidy that's available today that was part of the Affordable Care Act. It's available to groups of 25 or less with average salaries and their employee block of $50,000 a year or less.

The adoption rate of that tax credit is 3 percent, meaning 3 percent of the groups that are eligible for that assistance are taking it. And that's the subsidy that -- for small groups -- becomes exchange exclusive as of October. So if that's the adoption rate now -- if you look at the precedent of the small group exchanges in Massachusetts and Utah, both of which have captured less than 1 percent of their small group markets -- that tells you a little bit about where the opportunity is.

So, you know, I won't expand. I think these other bullets we've already covered in the earlier slides. I'll move instead to slide 22 where we want to talk about things to consider. And then, you know, one of those key things, of course as you're talking to your clients is, you know, do your clients think public exchanges would be viable and do they think it's something their employees might see as attractive?

You know, will the states be ready is a big question. And it's a big focus of tension right now on Capitol Hill. We saw Max Baucus,, who in many ways is the, you know, Congressional parent of the Affordable Care Act, express publicly last week that he was concerned that the implementation was a train wreck. But all indications are that -- at least from the standpoint of technical platform readiness -- that, you know, there will be a solution everywhere in the country, at least for IVL. The quality of that solution might be suspect. I don't know, it's probably going to be iterated over time. It's not going to be perfect at launch, but there will be something out there.

The affordability question, of course, is key, for some folks. Because of the subsidy opportunity, there'll be significant opportunity to get an affordable plan. But for some others it won't out run - the rate shock will not be out run by the subsidy opportunity.

So what I really want to do is - I'm going to transition back over to Colleen because I want to leave time for questions. We'll leave you with these slides -- maybe as takeaway slides -- to think about questions you might want to consider or ask or think about as you deal with your clients. But I don't want to run out the clock.

Colleen Rackely-Cuda:  Thank you, Paul. And if you look on slide 24 I just want to draw your attention to some of the other tools and resources available to you. You can go directly to our health reform website under You can access it directly or you can go to and get there as well.

Inside the Health Reform Connection website we also have a special page just for exchanges. There's a video out there that you can watch -- very brief, well done -- that you'll enjoy. And a lot of frequently asked questions about health care reform overall, exchanges, how things are moving. And there's also a tax credit calculator – a link to go out to see if this is something that you would be able to benefit from as we move into next year.

So, we again, we are very pleased to have this time with you today. We are committed to continuing to transform the health care delivery system, we continue to advocate on behalf of our customers and our business, our country to have more affordable options available that improve outcomes and reduce costs. So we continue to work together with the industry and the government agencies to achieve that goal. So we do all have a role to play here.