As the guy leading work on Tennessee’s health insurance exchange, Brian Haile is watching intently as U.S. Supreme Court legal arguments wrap up today to determine whether the federal health reform law is constitutional.
Haile says he’s fascinated by the legal debate, but he also considers the case a distraction to state planning efforts that eventually will determine whether Tennessee sets up an exchange of its own to offer insurance — or allows the federal government to operate the one planned here.
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But state authorities also see a need to keep their planning process going forward in case the reforms stay in place. Many argue that if an exchange must be created, it would be better for the state to run it since local officials presumably have a better grasp of Tennessee’s insurance market than federal bureaucrats.
So far, state officials have received $4.85 million in federal grants to fund the planning — including actuarial studies. Consumers would be able to buy coverage on the exchanges, including subsidized plans for people with limited incomes.
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As it stands now, states will have multiple chances beginning after this fall’s U.S. presidential elections to apply for funds to set up their own exchanges. An earlier requirement of a June 29 deadline was dumped in favor of a series of much later dates.
“Essentially, we can wait to see what happens with the Supreme Court and see the outcome of the elections before asking the state legislators to pass enabling legislation,” Haile said.
Nashville’s health-care community is also keeping a keen eye on the Supreme Court hearing. The outcome has implications for players such as hospital chains and surgery centers.
http://www.tennessean.com/article/20120328/COLUMNIST03/303280107/Getahn-Ward-TN-studies-health-exchange-despite-legal-distraction
Hat Tip: The Tennessean
Wednesday, March 28, 2012
Tuesday, March 27, 2012
National- Final Insurance Exchange Rule Prompts Concerns About Out-Of-Network Care
Federal officials have finalized regulations to guide states during the development of the health insurance exchanges that millions of Americans will count on to purchase coverage starting in 2014, as authorized by the health system reform law.
Overall, initial reaction to the 644-page rule's release on March 12 was positive. Health care organizations generally praised the Dept. of Health and Human Services for maintaining state flexibility in the rule, but some groups were critical of provisions designed to govern the adequacy of networks of physicians and other health professionals.
Additional standards should have been established to strengthen access protection in poor communities and rural areas and ensure that out-of-network care will be covered at no additional cost when in-network care is unavailable, said Blair Childs of Premier Inc. He's senior vice president of public affairs for the purchasing and quality improvement alliance in Charlotte, N.C.
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Giving states leeway to steer their own exchanges was a key theme in the final rule. Health industry representatives praised HHS for relying on states to design insurance marketplaces that fit in with consumer insurance markets.
"This rule recognizes that states are in the best position to establish exchanges, because they have the experience and local-market knowledge needed to best meet consumers' needs," said Karen Ignagni, president and CEO of America's Health Insurance Plans. "States need to be given flexibility to ensure that individuals, families and small businesses have access to options that work best for them."
HHS has awarded 49 states and the District of Columbia a total of $50 million for planning the development of websites that people can use to review insurance policies and purchase coverage. An additional $667 million in grants have been awarded to 33 states to build the infrastructure of the exchanges.
http://www.ama-assn.org/amednews/2012/03/26/gvsa0326.htm
Hat Tip: American Medical News
Overall, initial reaction to the 644-page rule's release on March 12 was positive. Health care organizations generally praised the Dept. of Health and Human Services for maintaining state flexibility in the rule, but some groups were critical of provisions designed to govern the adequacy of networks of physicians and other health professionals.
Additional standards should have been established to strengthen access protection in poor communities and rural areas and ensure that out-of-network care will be covered at no additional cost when in-network care is unavailable, said Blair Childs of Premier Inc. He's senior vice president of public affairs for the purchasing and quality improvement alliance in Charlotte, N.C.
...
Giving states leeway to steer their own exchanges was a key theme in the final rule. Health industry representatives praised HHS for relying on states to design insurance marketplaces that fit in with consumer insurance markets.
"This rule recognizes that states are in the best position to establish exchanges, because they have the experience and local-market knowledge needed to best meet consumers' needs," said Karen Ignagni, president and CEO of America's Health Insurance Plans. "States need to be given flexibility to ensure that individuals, families and small businesses have access to options that work best for them."
HHS has awarded 49 states and the District of Columbia a total of $50 million for planning the development of websites that people can use to review insurance policies and purchase coverage. An additional $667 million in grants have been awarded to 33 states to build the infrastructure of the exchanges.
http://www.ama-assn.org/amednews/2012/03/26/gvsa0326.htm
Hat Tip: American Medical News
Maryland- House & Senate Approve Health Exchange Bill
A new health insurance marketplace for Maryland residents and businesses and individuals received initial approval from both the Maryland House and Senate on Monday.
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In a statement, Lt. Gov. Anthony Brown described the legislation as “one of the most critical components of our efforts to reduce costs, expand access and improve the quality of care for Maryland families.”
Both the Senate and House approved exchange bills (SB 238/HB 443); once each bill crosses over and is approved by the opposite chamber, the legislation can be sent to Gov. Martin O’Malley for the final OK.
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In a statement, Lt. Gov. Anthony Brown described the legislation as “one of the most critical components of our efforts to reduce costs, expand access and improve the quality of care for Maryland families.”
Both the Senate and House approved exchange bills (SB 238/HB 443); once each bill crosses over and is approved by the opposite chamber, the legislation can be sent to Gov. Martin O’Malley for the final OK.
Hat Tip: Washington Business Journal
New York- Gov. Cuomo Says He’ll Go It Alone On Health Exchanges
Gov. Andrew Cuomo held a cabinet meeting this afternoon to tout the deal with lawmakers on a 2013-14 budget, saying the agreement will help fuel the economy and limit state spending.
He also said he would issue an executive order this week to create a health-care exchange, which is mandated by the federal government but has stalled in the Republican-led Senate. Cuomo now believes he doesn’t need legislation to create the exchanges for businesses and individuals to find health insurance.
http://polhudson.lohudblogs.com/2012/03/27/cuomo-praises-budget-deal-says-hell-go-it-alone-on-health-exchanges/
Hat Tip: Politics on the Hudson
He also said he would issue an executive order this week to create a health-care exchange, which is mandated by the federal government but has stalled in the Republican-led Senate. Cuomo now believes he doesn’t need legislation to create the exchanges for businesses and individuals to find health insurance.
http://polhudson.lohudblogs.com/2012/03/27/cuomo-praises-budget-deal-says-hell-go-it-alone-on-health-exchanges/
Hat Tip: Politics on the Hudson
Missouri- Lt. Gov. Kinder: State Health Exchanges are the “Gateway to Obamacare”
Lt. Gov. Peter Kinder was among the hundreds of protestors in Jefferson City Tuesday voicing their opposition to the new health care law, on the same day that the United States Supreme Court was debating the constitutionality of the law’s individual coverage requirement.
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In addition to coinciding with the Court’s oral arguments, the Tuesday rallies also came on the same day that the state Senate was debating legislation that would ban state-level health care exchanges until approved by voters.
State lawmakers have blocked millions of dollars in federal funds for the exchanges, a key component of implementing the entire health care law.
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Some Missouri Republicans initially supported the creation of exchanges. While members of the Missouri Senate have opposed them from the start, original legislation passed in 2010 with unanimous consent of the Missouri House of Representatives, including the consent of House Speaker Steven Tilley, who spoke to the rallies Tuesday in opposition to the federal law. At the time, supporters argued that if the states did not establish the exchanges, the federal government would.
http://politicmo.com/2012/03/27/kinder-state-level-exchanges-are-a-gateway-to-obamacare/
Hat Tip: PoliticMo.com
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In addition to coinciding with the Court’s oral arguments, the Tuesday rallies also came on the same day that the state Senate was debating legislation that would ban state-level health care exchanges until approved by voters.
State lawmakers have blocked millions of dollars in federal funds for the exchanges, a key component of implementing the entire health care law.
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Some Missouri Republicans initially supported the creation of exchanges. While members of the Missouri Senate have opposed them from the start, original legislation passed in 2010 with unanimous consent of the Missouri House of Representatives, including the consent of House Speaker Steven Tilley, who spoke to the rallies Tuesday in opposition to the federal law. At the time, supporters argued that if the states did not establish the exchanges, the federal government would.
http://politicmo.com/2012/03/27/kinder-state-level-exchanges-are-a-gateway-to-obamacare/
Hat Tip: PoliticMo.com
Monday, March 26, 2012
Opinion-New Jersey: Obamacare Health-Insurance Exchanges Are Set Up to Fail
Earlier this month the state Senate sent to the governor’s desk a bill that would create a health exchange in New Jersey. Chris Christie has not yet said whether he’ll sign the bill.
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You probably haven’t read much about this issue for a simple reason: It’s incredibly complicated. The exchange in question would have to coordinate buyers with insurers in a system relying on federal tax credits that could vary from month to month based on the insured person’s income.
Already insured? You’re not off the hook. The exchange would have the power to regulate your current policy and could impose a surcharge to cover the cost of running its operations.
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Think of that system and you will have a good idea of where these exchanges could end up – but with one big difference. Americans will accept limits on their cars, but not on their bodies.
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Huh? Medicare is a single-payer system that is just one stop short of socialized medicine. Obamacare, for all its faults, relies on the market to a much greater degree than Medicare. That’s why that Romney guy supported it back when he was governor of Massachusetts.
The real threat is not that Obamacare will take over Medicare. It’s the other way around, says Mike Cannon, a health-care expert with the free-market Cato Institute in Washington.
“These exchanges are built to fail,” said Cannon. “They’ll drive private insurance companies out of the market. When they do, the whole thing will collapse.”
http://blog.nj.com/njv_paul_mulshine/2012/03/obamacare_health-insurance_exc.html
Hat Tip: The Star Ledger
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You probably haven’t read much about this issue for a simple reason: It’s incredibly complicated. The exchange in question would have to coordinate buyers with insurers in a system relying on federal tax credits that could vary from month to month based on the insured person’s income.
Already insured? You’re not off the hook. The exchange would have the power to regulate your current policy and could impose a surcharge to cover the cost of running its operations.
...
Think of that system and you will have a good idea of where these exchanges could end up – but with one big difference. Americans will accept limits on their cars, but not on their bodies.
...
Huh? Medicare is a single-payer system that is just one stop short of socialized medicine. Obamacare, for all its faults, relies on the market to a much greater degree than Medicare. That’s why that Romney guy supported it back when he was governor of Massachusetts.
The real threat is not that Obamacare will take over Medicare. It’s the other way around, says Mike Cannon, a health-care expert with the free-market Cato Institute in Washington.
“These exchanges are built to fail,” said Cannon. “They’ll drive private insurance companies out of the market. When they do, the whole thing will collapse.”
http://blog.nj.com/njv_paul_mulshine/2012/03/obamacare_health-insurance_exc.html
Hat Tip: The Star Ledger
Opinion- Redo Hawaii Health Exchange Model
Legislators and other state officials are now in the midst of setting up Hawaii's exchange, dubbed the Hawaii Health Connector, but they need to take a breath and reconsider what they're doing.
A group of public-interest organizations has rightly sounded an alarm about how Act 205, which enabled the setup of the exchange, passed last year without sufficient scrutiny and debate.
At the center of this year's storm is the issue of incorporating insurance-industry advice in the formation of the health plans without leaving consumers and their advocates out in the cold.
Advocates say that the current slate of appointees nominated by Gov. Neil Abercrombie include representatives of the Hawaii Medical Service Association, Kaiser Permanente, Hawaii Primary Care Association, Maui Medical Group, HMA Inc. and Hawaii Dental Service, and that all these entities have a conflict of interest as voting members of the board.
Those advocates are pressing for amendments to the law.
A key change would bar the inclusion of exchange board members who have a financial interest in the plans.
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A better model would be one similar to the California Health Benefit Exchange, described as an "independent public entity within state government."
Before the House vote this week, state Rep. Joseph Souki expressed his misgivings about the private nonprofit setup and his preference for a "quasi-government" exchange.
"This is extremely important because you are going to be providing health services for people who cannot qualify for other health services," Souki said.
He's right. SB 2434 attempts to incorporate a measure of public transparency into a private nonprofit structure.
The ideal solution would be a broader revision of Act 205, one that would both allow for industry consultation on the creation of health plans without conflicts among the voting members, and for the public to be engaged.
http://insurancenewsnet.com/article.aspx?id=336235
Hat Tip: InsuranceNewsNet.com
A group of public-interest organizations has rightly sounded an alarm about how Act 205, which enabled the setup of the exchange, passed last year without sufficient scrutiny and debate.
At the center of this year's storm is the issue of incorporating insurance-industry advice in the formation of the health plans without leaving consumers and their advocates out in the cold.
Advocates say that the current slate of appointees nominated by Gov. Neil Abercrombie include representatives of the Hawaii Medical Service Association, Kaiser Permanente, Hawaii Primary Care Association, Maui Medical Group, HMA Inc. and Hawaii Dental Service, and that all these entities have a conflict of interest as voting members of the board.
Those advocates are pressing for amendments to the law.
A key change would bar the inclusion of exchange board members who have a financial interest in the plans.
...
A better model would be one similar to the California Health Benefit Exchange, described as an "independent public entity within state government."
Before the House vote this week, state Rep. Joseph Souki expressed his misgivings about the private nonprofit setup and his preference for a "quasi-government" exchange.
"This is extremely important because you are going to be providing health services for people who cannot qualify for other health services," Souki said.
He's right. SB 2434 attempts to incorporate a measure of public transparency into a private nonprofit structure.
The ideal solution would be a broader revision of Act 205, one that would both allow for industry consultation on the creation of health plans without conflicts among the voting members, and for the public to be engaged.
http://insurancenewsnet.com/article.aspx?id=336235
Hat Tip: InsuranceNewsNet.com
Opinion- New Yorkers Need a Health Insurance Exchange
New York has experienced a rapid increase in the number of people without health insurance. For the uninsured, particularly those suffering from chronic illnesses, the consequences can be devastating. However, there is hope: New York could create a health insurance exchange to enable those without health coverage and small businesses to purchase affordable, high quality insurance.
According to the U.S. Census, over 2.5 million New Yorkers are uninsured. The exchange would negotiate with health insurers to offer affordable, high quality insurance. The concept of a health exchange is not new. Massachusetts created one in 2006 and now more than 98 percent of its residents have health insurance coverage. The Massachusetts system was the model for the federal health care reform law. For those states that set up exchanges, the federal government will pick up the tab for start-up costs.
Fourteen states have already created exchanges, including most recently in Mississippi where the Republican insurance commissioner stated, "It's not a Republican idea. It is not a Democratic idea. It is a universal idea, and it has been around a long time.” In our neighboring state New Jersey, the legislature just passed an exchange bill and sent it to Gov. Chris Christie for his consideration.
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The main issue for the Senate is that an exchange “costs too much.” According to the Senate Majority Leader, “Federal health reforms could cost (New York) taxpayers more than $65 billion for the Medicaid portion alone.” That cost estimate is based on exaggerated figures from a think tank, The Cato Institute. One example of how the cost is inflated is that The Cato Institute averages “cost per enrollee” based on current spending and assumes cost will be the same for all new Medicaid enrollees. Studies have shown that those who are eligible but not enrolled in Medicaid tend to be healthier and, once covered, cost less than those covered previously.
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Creation of an exchange is vitally important to the American Cancer Society because about 10 percent of all cancer patients lack health insurance when they are diagnosed. As a result, they may choose to delay treatment, thus facing more debilitating therapies later with dim prognoses. No one should have to choose between paying the rent and getting life-saving cancer treatment.
For the estimated 1 million New Yorkers who will get health insurance through the exchange, arguments don’t matter. They need coverage, not rhetoric. Action to create a health exchange is the first step of many that must be accomplished soon if the state will be ready to begin enrolling the uninsured and offer low-cost insurance for small businesses in 2014. The governor and Assembly have done their part. It’s time for the Senate to do its part and include the exchange in its final budget.
http://www.lohud.com/article/20120325/OPINION/303250079/New-Yorkers-need-health-insurance-exchange
Hat Tip: LoHud.Com
According to the U.S. Census, over 2.5 million New Yorkers are uninsured. The exchange would negotiate with health insurers to offer affordable, high quality insurance. The concept of a health exchange is not new. Massachusetts created one in 2006 and now more than 98 percent of its residents have health insurance coverage. The Massachusetts system was the model for the federal health care reform law. For those states that set up exchanges, the federal government will pick up the tab for start-up costs.
Fourteen states have already created exchanges, including most recently in Mississippi where the Republican insurance commissioner stated, "It's not a Republican idea. It is not a Democratic idea. It is a universal idea, and it has been around a long time.” In our neighboring state New Jersey, the legislature just passed an exchange bill and sent it to Gov. Chris Christie for his consideration.
...
The main issue for the Senate is that an exchange “costs too much.” According to the Senate Majority Leader, “Federal health reforms could cost (New York) taxpayers more than $65 billion for the Medicaid portion alone.” That cost estimate is based on exaggerated figures from a think tank, The Cato Institute. One example of how the cost is inflated is that The Cato Institute averages “cost per enrollee” based on current spending and assumes cost will be the same for all new Medicaid enrollees. Studies have shown that those who are eligible but not enrolled in Medicaid tend to be healthier and, once covered, cost less than those covered previously.
...
Creation of an exchange is vitally important to the American Cancer Society because about 10 percent of all cancer patients lack health insurance when they are diagnosed. As a result, they may choose to delay treatment, thus facing more debilitating therapies later with dim prognoses. No one should have to choose between paying the rent and getting life-saving cancer treatment.
For the estimated 1 million New Yorkers who will get health insurance through the exchange, arguments don’t matter. They need coverage, not rhetoric. Action to create a health exchange is the first step of many that must be accomplished soon if the state will be ready to begin enrolling the uninsured and offer low-cost insurance for small businesses in 2014. The governor and Assembly have done their part. It’s time for the Senate to do its part and include the exchange in its final budget.
http://www.lohud.com/article/20120325/OPINION/303250079/New-Yorkers-need-health-insurance-exchange
Hat Tip: LoHud.Com
Illinois- Gov. Quinn Seeking Spring Action On Exchange
There’s still time for the Illinois General Assembly to pass legislation creating a state-operated health insurance exchange, but Gov. Pat Quinn hopes lawmakers don’t wait until June to act, a Quinn aide said Monday.
Some legislators have indicated they want to delay a decision until summer, when the U.S. Supreme Court is expected to rule on whether the federal Affordable Care Act and the act’s individual insurance mandate are constitutional.
However, there will be problems if a bill to set up a board of directors and funding for a regulated insurance clearinghouse in Illinois isn’t passed until June, said Michael Gelder, the Democratic governor’s senior health-care policy adviser.
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Illinois’ proposed self-supporting exchange would be a place for individuals and small businesses to buy health insurance and potentially qualify for federal subsidies to make premiums and other out-of-pocket costs more affordable.
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State Rep. Frank Mautino, D-Spring Valley, said he is working on a legislative compromise that could pass the House and Senate this spring in time for Quinn to sign it into law. Passage of a law would ensure that Illinois qualifies for more than $80 million in federal startup grants, according to administration officials.
The grants would pay for a massive upgrade of state government’s computer capacity and would have the added benefit of helping the state enact a 2011 Illinois law designed to cut down on Medicaid abuse and make the program more efficient.
http://www.sj-r.com/top-stories/x1184534252/Quinn-seeking-spring-action-on-state-health-care-preparation
Hat Tip: State Journal-Register
Some legislators have indicated they want to delay a decision until summer, when the U.S. Supreme Court is expected to rule on whether the federal Affordable Care Act and the act’s individual insurance mandate are constitutional.
However, there will be problems if a bill to set up a board of directors and funding for a regulated insurance clearinghouse in Illinois isn’t passed until June, said Michael Gelder, the Democratic governor’s senior health-care policy adviser.
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Illinois’ proposed self-supporting exchange would be a place for individuals and small businesses to buy health insurance and potentially qualify for federal subsidies to make premiums and other out-of-pocket costs more affordable.
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State Rep. Frank Mautino, D-Spring Valley, said he is working on a legislative compromise that could pass the House and Senate this spring in time for Quinn to sign it into law. Passage of a law would ensure that Illinois qualifies for more than $80 million in federal startup grants, according to administration officials.
The grants would pay for a massive upgrade of state government’s computer capacity and would have the added benefit of helping the state enact a 2011 Illinois law designed to cut down on Medicaid abuse and make the program more efficient.
http://www.sj-r.com/top-stories/x1184534252/Quinn-seeking-spring-action-on-state-health-care-preparation
Hat Tip: State Journal-Register
Virginia- Deadline Looms for Virginia to Set Health Benefit Exchanges
While Virginia waits for the U.S. Supreme Court to act on the constitutionality of federal health care reform, the clock keeps ticking on a deadline for states to establish health benefit exchanges or accept federal control of the new market.
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With the legal challenge pending, Gov. Bob McDonnell and other Republican leaders in the General Assembly thwarted legislative efforts this year to set state policy for creating a health insurance exchange in Virginia.
But the McDonnell administration is working behind the scenes on key components of health care reform that must be in place by a Jan. 1, 2013, deadline to demonstrate Virginia's readiness to establish a state-run exchange by 2014.
Consumer advocates and health insurers say the state has no time to spare.
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Eleven health insurance plans already want to participate in a Virginia exchange, but they are waiting for answers from the governor and legislature, which would have to address the issues in a special session this year to meet the deadline.
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The Virginia Health Reform Initiative Advisory Council will begin meeting again next month to consider a number of pending policy concerns, but the group's recommendations to McDonnell last fall still haven't been endorsed by the governor or acted on by the General Assembly.
http://www2.timesdispatch.com/special_section/virginia-politics/2012/mar/26/tdmain01-deadline-looms-for-va-to-set-health-benef-ar-1793627/
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With the legal challenge pending, Gov. Bob McDonnell and other Republican leaders in the General Assembly thwarted legislative efforts this year to set state policy for creating a health insurance exchange in Virginia.
But the McDonnell administration is working behind the scenes on key components of health care reform that must be in place by a Jan. 1, 2013, deadline to demonstrate Virginia's readiness to establish a state-run exchange by 2014.
Consumer advocates and health insurers say the state has no time to spare.
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Eleven health insurance plans already want to participate in a Virginia exchange, but they are waiting for answers from the governor and legislature, which would have to address the issues in a special session this year to meet the deadline.
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The Virginia Health Reform Initiative Advisory Council will begin meeting again next month to consider a number of pending policy concerns, but the group's recommendations to McDonnell last fall still haven't been endorsed by the governor or acted on by the General Assembly.
http://www2.timesdispatch.com/special_section/virginia-politics/2012/mar/26/tdmain01-deadline-looms-for-va-to-set-health-benef-ar-1793627/
Hat Tip: Richmond Times-Dispatch
Minnesota- Gov. Dayton Criticizes Republican Health Insurance Exchange Efforts
Gov. Mark Dayton, a Democrat, sent a letter on Monday, March 26, criticizing Republican bills moving through the Legislature for taking a "piecemeal" and "ideological" approach to creating in Minnesota a health insurance exchange - a key piece of the federal health care legislation.
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On Monday night, the committee considered a bill from Sen. Tony Lourey, DFL-Kerrick, that calls for creating an exchange based on recommendations issued earlier this year by a Dayton-appointed task force. Republicans did not participate in the task force, saying it would simply serve as a rubber stamp for plans being developed with the Dayton administration.
Lourey suggested that his bill might represent a middle ground approach to creating a health exchange. Consumer advocates might want more protections, he said, while free-market advocates might want a smaller role for the government.
But that view apparently wasn't shared by Republicans on the committee. Several raised concerns that the health exchange would wind up being an expensive proposition for the state.
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Last month, Hann and Rep. Steve Gottwalt, R-St. Cloud, introduced a bill that would give individuals access to personal health premium accounts, where they could amass funds from a variety of sources to buy health care coverage. At the time, Gottwalt said those sources could include premium subsidies from the government.
A second Republican bill introduced this session would require health care "navigators" to be licensed. Navigators are a key part of the health exchange structure established by the federal health care reform law, which Congress passed in 2010.
A third bill, which was introduced by Gerlach, would place limits on the sort of policies that could be sold through a health exchange. The bill also would require that private market shareholders be part of the governance structure for a health exchange.
http://www.twincities.com/ci_20258671/dayton-criticizes-republican-health-insurance-exchange-efforts
Hat Tip: Pioneer Press
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On Monday night, the committee considered a bill from Sen. Tony Lourey, DFL-Kerrick, that calls for creating an exchange based on recommendations issued earlier this year by a Dayton-appointed task force. Republicans did not participate in the task force, saying it would simply serve as a rubber stamp for plans being developed with the Dayton administration.
Lourey suggested that his bill might represent a middle ground approach to creating a health exchange. Consumer advocates might want more protections, he said, while free-market advocates might want a smaller role for the government.
But that view apparently wasn't shared by Republicans on the committee. Several raised concerns that the health exchange would wind up being an expensive proposition for the state.
...
Last month, Hann and Rep. Steve Gottwalt, R-St. Cloud, introduced a bill that would give individuals access to personal health premium accounts, where they could amass funds from a variety of sources to buy health care coverage. At the time, Gottwalt said those sources could include premium subsidies from the government.
A second Republican bill introduced this session would require health care "navigators" to be licensed. Navigators are a key part of the health exchange structure established by the federal health care reform law, which Congress passed in 2010.
A third bill, which was introduced by Gerlach, would place limits on the sort of policies that could be sold through a health exchange. The bill also would require that private market shareholders be part of the governance structure for a health exchange.
http://www.twincities.com/ci_20258671/dayton-criticizes-republican-health-insurance-exchange-efforts
Hat Tip: Pioneer Press
National- States Ponder Creation of Health Exchanges
Even before the Supreme Court rules on the health care law, states are debating how far they should go to set up the health care exchanges that the law would require them to create. Most states have started laying the groundwork for the exchanges, but others are banking on the nation’s high court striking down the law instead.
Florida Governor Rick Scott, a former hospital executive, is one of the chief opponents of the law. He told a Tampa radio station there is no point in setting up the exchanges.
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In Michigan, the question of setting up an exchange pits Republicans in the state House against the administration of Republican Governor Rick Snyder, reports the Lansing bureau of The Associated Press.
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In New Mexico, the Republican doctor in charge of making sure the state complied with the federal law resigned last week, writes The (Santa Fe) New Mexican. Dr. Dan Derksen told the paper he lost the internal battle over how to roll out the law. New Mexico has the second-highest rate of uninsured residents of any state, trailing only Texas.
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Arizona Governor Jan Brewer, who has had a frosty relationship with President Barack Obama, is nonetheless setting up a health insurance exchange. “Brewer’s advisers,” explains The Arizona Republic, “see it as a practical way to put Arizona's imprint on part of the health law that, if upheld, will have far-ranging impact on consumers, businesses and the economy.”
Washington Governor Christine Gregoire, a Democrat, approved legislation Friday (March 26) calling for the creation of an exchange there, but vetoed a provision that would have automatically closed down the exchange if it lost money, reports the AP.
Meanwhile, New York Governor Andrew Cuomo, already mentioned as a potential Democratic presidential candidate in 2016, says he may have to drop plans for an exchange, because the Republican-controlled Senate objects to it.
http://www.stateline.org/live/details/story?contentId=641513
Hat Tip: Stateline.Org
Florida Governor Rick Scott, a former hospital executive, is one of the chief opponents of the law. He told a Tampa radio station there is no point in setting up the exchanges.
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In Michigan, the question of setting up an exchange pits Republicans in the state House against the administration of Republican Governor Rick Snyder, reports the Lansing bureau of The Associated Press.
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In New Mexico, the Republican doctor in charge of making sure the state complied with the federal law resigned last week, writes The (Santa Fe) New Mexican. Dr. Dan Derksen told the paper he lost the internal battle over how to roll out the law. New Mexico has the second-highest rate of uninsured residents of any state, trailing only Texas.
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Arizona Governor Jan Brewer, who has had a frosty relationship with President Barack Obama, is nonetheless setting up a health insurance exchange. “Brewer’s advisers,” explains The Arizona Republic, “see it as a practical way to put Arizona's imprint on part of the health law that, if upheld, will have far-ranging impact on consumers, businesses and the economy.”
Washington Governor Christine Gregoire, a Democrat, approved legislation Friday (March 26) calling for the creation of an exchange there, but vetoed a provision that would have automatically closed down the exchange if it lost money, reports the AP.
Meanwhile, New York Governor Andrew Cuomo, already mentioned as a potential Democratic presidential candidate in 2016, says he may have to drop plans for an exchange, because the Republican-controlled Senate objects to it.
http://www.stateline.org/live/details/story?contentId=641513
Hat Tip: Stateline.Org
Friday, March 23, 2012
Michigan- House GOP Blocks Efforts To Set Up Health Exchange
Michigan is making little progress toward creating a statewide health exchange required by federal law, held up by House Republicans who want to wait until the U.S. Supreme Court decides if the law is constitutional.
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But state Licensing and Regulatory Affairs director Steve Hilfinger, who last year was given the task of creating the exchange by Gov. Rick Snyder, worries Michigan could run out of time to put a state health exchange in place by January if it can't start planning now. If it fails to meet the deadline, the federal government would install its own exchange where consumers could compare private health insurance plans.
That's why the director would like House Republicans to approve spending the money.
http://www.detroitnews.com/article/20120323/POLITICS02/203230429/1361/Mich.-House-GOP-blocks-efforts-to-set-up-health-exchange
Hat Tip: Detroit News
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But state Licensing and Regulatory Affairs director Steve Hilfinger, who last year was given the task of creating the exchange by Gov. Rick Snyder, worries Michigan could run out of time to put a state health exchange in place by January if it can't start planning now. If it fails to meet the deadline, the federal government would install its own exchange where consumers could compare private health insurance plans.
That's why the director would like House Republicans to approve spending the money.
http://www.detroitnews.com/article/20120323/POLITICS02/203230429/1361/Mich.-House-GOP-blocks-efforts-to-set-up-health-exchange
Hat Tip: Detroit News
Washington- Health Care Exchange Signed Into Law
Gov. Chris Gregoire and other Democratic officials marked Friday’s second anniversary of the signing of the Affordable Care Act – which Republicans prefer to call Obamacare – with a signing ceremony of their own.
Gregoire signed legislation to help set up health insurance exchanges in Washington, a system that would help individuals and small businesses shop for medical plans by 2014.
“The current (health care system) groans under its own weight,” Gregoire said at the signing ceremony. “We cannot afford health care today in America.”
...
The state exchange doesn’t go into effect until 2014, but state Insurance Commissioner Mike Kreidler said the state will need much of that time to set it up properly: “If we slow down and wait because of the uncertainty, we won’t meet the time limits.”
http://www.spokesman.com/stories/2012/mar/23/health-exchange-signed-law/
Hat Tip: The Spokesman-Review
Gregoire signed legislation to help set up health insurance exchanges in Washington, a system that would help individuals and small businesses shop for medical plans by 2014.
“The current (health care system) groans under its own weight,” Gregoire said at the signing ceremony. “We cannot afford health care today in America.”
...
The state exchange doesn’t go into effect until 2014, but state Insurance Commissioner Mike Kreidler said the state will need much of that time to set it up properly: “If we slow down and wait because of the uncertainty, we won’t meet the time limits.”
http://www.spokesman.com/stories/2012/mar/23/health-exchange-signed-law/
Hat Tip: The Spokesman-Review
Thursday, March 22, 2012
Wyoming- Health Exchange Group Meets Next Week in Casper
The group studying models for a Wyoming health insurance exchange will meet next week in Casper.
...
As it turns out, the Wyoming Business Coalition on Health is holding its own forum on exchanges earlier that day. So if you have a burning desire to study virtual insurance marketplaces, you can learn about exchanges in the morning and then watch one being developing in the afternoon.
http://trib.com/news/updates/health-exchange-group-meets-next-week-in-casper/article_6145c5a6-5b7f-56d9-8b07-832d4fe5a14c.html
Hat Tip: Casper Tribune
...
As it turns out, the Wyoming Business Coalition on Health is holding its own forum on exchanges earlier that day. So if you have a burning desire to study virtual insurance marketplaces, you can learn about exchanges in the morning and then watch one being developing in the afternoon.
http://trib.com/news/updates/health-exchange-group-meets-next-week-in-casper/article_6145c5a6-5b7f-56d9-8b07-832d4fe5a14c.html
Hat Tip: Casper Tribune
Utah- A View From the Beehive State
Of all the states, Utah may win for most complicated relationship with the federal health reform law. It’s one of just two states that now operates a health insurance exchange - the other being Massachusetts.
...
The Utah one looks quite different: There are no subsidies; nor are there standards for coverage. State officials like to compare it to a farmer’s market: Health insurers show up and sell their products, and subscribers decide whether to purchase. Utah is pretty hands-off with its exchange, which is run by just two state employees.
...
Utah Gov. Gary Herbert, a Republican, certainly hopes that his exchange will survive the federal health overhaul. “I’m cautiously optimistic our health care exchange will pass muster,” he said in an interview Wednesday.
...
The federal government almost certainly won’t let the Utah exchange stand as is, given requirements for exchanges under the Affordable Care Act. The state’s marketplace serves only small businesses right now, while the federal law requires states to allow individuals to purchase coverage. Federal law also mandates that the exchange connects to a state’s Medicaid office; Utah’s Connector does not.
...
Right now, Utah says it’s still far from getting the answers on the administration’s ground rules. While there are multiple regulations on the exchanges, there is little about the consequences for states that don’t comply.
http://www.washingtonpost.com/blogs/ezra-klein/post/on-the-health-care-act-a-view-from-utah/2012/03/21/gIQAkbfISS_blog.html
Hat Tip: Washington Post, WonkBlog, Sarah Kliff
...
The Utah one looks quite different: There are no subsidies; nor are there standards for coverage. State officials like to compare it to a farmer’s market: Health insurers show up and sell their products, and subscribers decide whether to purchase. Utah is pretty hands-off with its exchange, which is run by just two state employees.
...
Utah Gov. Gary Herbert, a Republican, certainly hopes that his exchange will survive the federal health overhaul. “I’m cautiously optimistic our health care exchange will pass muster,” he said in an interview Wednesday.
...
The federal government almost certainly won’t let the Utah exchange stand as is, given requirements for exchanges under the Affordable Care Act. The state’s marketplace serves only small businesses right now, while the federal law requires states to allow individuals to purchase coverage. Federal law also mandates that the exchange connects to a state’s Medicaid office; Utah’s Connector does not.
...
Right now, Utah says it’s still far from getting the answers on the administration’s ground rules. While there are multiple regulations on the exchanges, there is little about the consequences for states that don’t comply.
http://www.washingtonpost.com/blogs/ezra-klein/post/on-the-health-care-act-a-view-from-utah/2012/03/21/gIQAkbfISS_blog.html
Hat Tip: Washington Post, WonkBlog, Sarah Kliff
Maryland- Senate Committee Approves Health Exchange Bill
A new state health insurance exchange for Maryland residents is one step closer to being final after the Senate Finance Committee approved an exchange bill Wednesday evening.
The House Health and Government Operations Committee approved plans March 20 for the Maryland Health Benefit Exchange March 20. The measure is expected to reach the Senate and House floors in the coming days.
http://www.bizjournals.com/baltimore/news/2012/03/21/maryland-senate-committee-approves.html
Hat Tip: Baltimore Business Journal
The House Health and Government Operations Committee approved plans March 20 for the Maryland Health Benefit Exchange March 20. The measure is expected to reach the Senate and House floors in the coming days.
http://www.bizjournals.com/baltimore/news/2012/03/21/maryland-senate-committee-approves.html
Hat Tip: Baltimore Business Journal
Utah- Ditching Loaded Label ‘Health Exchange’
Utah is ditching the loaded label "health exchange" and looking to re-brand its online insurance portal to resonate more with consumers.
Plans to rename Utah’s Health Exchange and possibly scrap all references to the word "exchange" were announced this week at an advisory board meeting by its director, Patty Conner, who said the word carries negative connotations.
Initially plagued by high premiums and lackluster enrollment, Utah’s Health Exchange now insures 5,513 employees and their dependents at 225 small companies. Data also show that prices inside the exchange are lower or the same as those outside.
Whether she was referring to the shopping tool’s halting success, or public angst over Obama’s signature health overhaul, isn’t clear.
In an interview, Conner said the re-branding effort will be more of a publicity blitz geared toward drumming up business in preparation for 2014, when 300,000 uninsured Utahns will be forced under the federal health law to buy insurance.
http://www.sltrib.com/sltrib/news/53766136-78/exchange-health-utah-conner.html.csp
Hat Tip: The Salt Lake Tribune
Plans to rename Utah’s Health Exchange and possibly scrap all references to the word "exchange" were announced this week at an advisory board meeting by its director, Patty Conner, who said the word carries negative connotations.
Initially plagued by high premiums and lackluster enrollment, Utah’s Health Exchange now insures 5,513 employees and their dependents at 225 small companies. Data also show that prices inside the exchange are lower or the same as those outside.
Whether she was referring to the shopping tool’s halting success, or public angst over Obama’s signature health overhaul, isn’t clear.
In an interview, Conner said the re-branding effort will be more of a publicity blitz geared toward drumming up business in preparation for 2014, when 300,000 uninsured Utahns will be forced under the federal health law to buy insurance.
http://www.sltrib.com/sltrib/news/53766136-78/exchange-health-utah-conner.html.csp
Hat Tip: The Salt Lake Tribune
National- Even Reluctant States Design Health Insurance Exchanges
Virginia Republican Governor Bob McDonnell wants the U.S. Supreme Court to strike down the 2010 health-care overhaul. That hasn’t stopped him from taking $1 million from the federal government to uphold one of the law’s top provisions. Virginia is using the money to help design a statewide market, or exchange, where uninsured people and small businesses can buy health coverage, starting in 2014.
...
U.S. officials haven’t disclosed rules for the federal exchange, raising the prospect that it might not be ready in time. That would make the states’ job even tougher, as they need to get tax and immigration data from Washington to identify who’s eligible for policies and whether they qualify for subsidies.
...
U.S. officials haven’t disclosed rules for the federal exchange, raising the prospect that it might not be ready in time. That would make the states’ job even tougher, as they need to get tax and immigration data from Washington to identify who’s eligible for policies and whether they qualify for subsidies.
...
States are better off complying with the health-care law instead of losing their power to regulate health services for millions of their residents, says former Tennessee Democratic Governor Philip Bredesen.
That’s not the sentiment in Louisiana, whose officials view the overhaul as unconstitutional and “just bad public policy” because it adds bureaucracy and doesn’t do enough to control health-care costs, says Bruce Greenstein, secretary of the state’s Department of Health and Hospitals. The state declined to start planning an exchange.
Arkansas also is sitting out the process because of disagreements between its Republican-controlled legislature and Democratic Governor Mike Beebe. Beebe won a $7.7 million federal grant last month to develop technology links between his existing Medicaid program and the exchange the federal government will run in the state.
Colorado, with the same partisan split between its governor and legislature, opted to strike a compromise and pass a law authorizing an exchange. The state has received $19 million in federal money so far and is weighing bids from 12 vendors to build the system.
http://www.businessweek.com/articles/2012-03-22/even-reluctant-states-design-health-insurance-exchanges
Hat Tip: Bloomberg BusinessWeek
States are better off complying with the health-care law instead of losing their power to regulate health services for millions of their residents, says former Tennessee Democratic Governor Philip Bredesen.
That’s not the sentiment in Louisiana, whose officials view the overhaul as unconstitutional and “just bad public policy” because it adds bureaucracy and doesn’t do enough to control health-care costs, says Bruce Greenstein, secretary of the state’s Department of Health and Hospitals. The state declined to start planning an exchange.
Arkansas also is sitting out the process because of disagreements between its Republican-controlled legislature and Democratic Governor Mike Beebe. Beebe won a $7.7 million federal grant last month to develop technology links between his existing Medicaid program and the exchange the federal government will run in the state.
Colorado, with the same partisan split between its governor and legislature, opted to strike a compromise and pass a law authorizing an exchange. The state has received $19 million in federal money so far and is weighing bids from 12 vendors to build the system.
http://www.businessweek.com/articles/2012-03-22/even-reluctant-states-design-health-insurance-exchanges
Hat Tip: Bloomberg BusinessWeek
New York- Senate Leader Casts Doubt on Health Exchanges
Senate Majority Leader Dean Skelos is casting doubt on whether the state budget will include a health exchange required under the federal health care act, saying there is too much uncertainty to create it now.
As part of the federal health care act backed by President Obama and approved by Congress, states are required to set up health exchanges so that the uninsured can buy the health care plans that they will be required to purchase when the act is fully implemented.
Negotiations on the health care exchange for New York began nearly a year ago, but an agreement fell through during the final week of the 2011 legislative session, when some Republican Senators objected to enacting any portion of what opponents call “Obamacare”.
This year, Governor Cuomo made a second attempt to enact the health exchanges. He has made them part of his new budget plan. But the Republican Leader of the Senate, Dean Skelos, says his GOP Majority is very reluctant to sign off on the exchanges.
http://wxxinews.org/post/senate-leader-casts-doubt-health-exchanges
Hat Tip: WXXI News - NPR
As part of the federal health care act backed by President Obama and approved by Congress, states are required to set up health exchanges so that the uninsured can buy the health care plans that they will be required to purchase when the act is fully implemented.
Negotiations on the health care exchange for New York began nearly a year ago, but an agreement fell through during the final week of the 2011 legislative session, when some Republican Senators objected to enacting any portion of what opponents call “Obamacare”.
This year, Governor Cuomo made a second attempt to enact the health exchanges. He has made them part of his new budget plan. But the Republican Leader of the Senate, Dean Skelos, says his GOP Majority is very reluctant to sign off on the exchanges.
http://wxxinews.org/post/senate-leader-casts-doubt-health-exchanges
Hat Tip: WXXI News - NPR
Tuesday, March 20, 2012
CO-Ops- Utah: May Start Health Insurance CO-OP
Where some saw doom in federal health reform, Shaun Greene saw a business opportunity.
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Captivated by a little-known provision for health insurance cooperatives, he convinced a powerhouse group of industry leaders to start one in Utah.
For now, Aarches Community Health Care is a business plan, which its founders will unveil Wednesday at a community forum in Taylorsville.
...
Like electric, farm and dairy co-ops in rural parts of America, health co-ops, or "Consumer Operated and Oriented Health Plans," provide an under-produced good or service — in this case, affordable health coverage.
The idea was championed by a bipartisan group in Congress as an alternative to a public option, or government-run health plan.
...
"We lost six months, but now we have a better business plan," said Greene, who will spend the next year traveling the state to promote it.
The group faces fierce competition considering Utah’s insurance market is already dominated by two nonprofits, SelectHealth and Regence BlueCross BlueShield.
But it will open for business in 2014, just as 300,000 uninsured Utahns will be shopping for the best insurance deals on state exchanges.
http://www.sltrib.com/sltrib/news/53754213-78/health-care-baker-public.html.csp
Hat Tip: The Salt Lake Tribune
...
Captivated by a little-known provision for health insurance cooperatives, he convinced a powerhouse group of industry leaders to start one in Utah.
For now, Aarches Community Health Care is a business plan, which its founders will unveil Wednesday at a community forum in Taylorsville.
...
Like electric, farm and dairy co-ops in rural parts of America, health co-ops, or "Consumer Operated and Oriented Health Plans," provide an under-produced good or service — in this case, affordable health coverage.
The idea was championed by a bipartisan group in Congress as an alternative to a public option, or government-run health plan.
...
"We lost six months, but now we have a better business plan," said Greene, who will spend the next year traveling the state to promote it.
The group faces fierce competition considering Utah’s insurance market is already dominated by two nonprofits, SelectHealth and Regence BlueCross BlueShield.
But it will open for business in 2014, just as 300,000 uninsured Utahns will be shopping for the best insurance deals on state exchanges.
http://www.sltrib.com/sltrib/news/53754213-78/health-care-baker-public.html.csp
Hat Tip: The Salt Lake Tribune
New Jersey- Christie Being Pushed to Support 'Health Exchange'
With the state Legislature expected to approve a bill Thursday creating a "health exchange" — the cornerstone of the federal health care law that will help people shop for cheaper coverage — a group of family, consumer and senior citizen advocates today challenged Gov. Chris Christie to support the effort.
But Christie, a Republican, has not committed to creating a health exchange, and won't make a decision until the U.S. Supreme Court decides this year whether the Affordable Care Act is constitutional, state Banking and Insurance spokesman Marshall McKnight said. The nation's highest court will hear arguments on the case in two weeks.
Waiting for the Supreme Court's decision, however, is "leaving millions of dollars on the table," said Ray Castro, a senior analyst at New Jersey Policy Perspective, a liberal leaning think tank which participated in the Trenton press conference to call attention to the bill. The Christie administration has delayed applying for larger grants, unlike Pennsylvania which received $30 million and New York that qualified for $40 million.
http://www.nj.com/news/index.ssf/2012/03/christie_being_pushed_to_suppo.html
Hat Tip: NJ.Com
But Christie, a Republican, has not committed to creating a health exchange, and won't make a decision until the U.S. Supreme Court decides this year whether the Affordable Care Act is constitutional, state Banking and Insurance spokesman Marshall McKnight said. The nation's highest court will hear arguments on the case in two weeks.
Waiting for the Supreme Court's decision, however, is "leaving millions of dollars on the table," said Ray Castro, a senior analyst at New Jersey Policy Perspective, a liberal leaning think tank which participated in the Trenton press conference to call attention to the bill. The Christie administration has delayed applying for larger grants, unlike Pennsylvania which received $30 million and New York that qualified for $40 million.
http://www.nj.com/news/index.ssf/2012/03/christie_being_pushed_to_suppo.html
Hat Tip: NJ.Com
National- New Rules for Setting Up Health Exchanges
The feds have issued new rules on how the exchanges will be formed and how they will work.
Some highlights:
-States can decide whether their exchanges should be operated by a non-profit organization or a public agency, how participating plans will be selected, and whether to partner with the Department of Health and Human services for some key functions
-a state can choose to operate its exchange in partnership with other states through a regional exchange or it can operate multiple exchanges that cover distinct areas within the state
-states are allowed to police insurers by using “secret shoppers” to ensure sick people aren’t discouraged from signing up
-exchanges must operate a website that facilitates comparisons among qualified health plans and operate a customer support hotline
-exchanges must conduct outreach to educate consumers regarding the exchanges
-exchanges must determine and explain the eligibility requirements for enrollment in a qualified health plan (one that satisfies minimum benefit standards), and
-individuals participating in exchanges must be allowed to change from one qualified plan to another outside of open enrollment if certain things occur — like marriage, birth or adoption.
Even though the new rules don’t impact employers directly, companies can use them to determine what they should offer for their plans to be considered competitive when measured against plans offered in an exchange.
http://www.hrmorning.com/new-rules-for-setting-up-health-exchanges/
Hat Tip: HR Morning
Some highlights:
-States can decide whether their exchanges should be operated by a non-profit organization or a public agency, how participating plans will be selected, and whether to partner with the Department of Health and Human services for some key functions
-a state can choose to operate its exchange in partnership with other states through a regional exchange or it can operate multiple exchanges that cover distinct areas within the state
-states are allowed to police insurers by using “secret shoppers” to ensure sick people aren’t discouraged from signing up
-exchanges must operate a website that facilitates comparisons among qualified health plans and operate a customer support hotline
-exchanges must conduct outreach to educate consumers regarding the exchanges
-exchanges must determine and explain the eligibility requirements for enrollment in a qualified health plan (one that satisfies minimum benefit standards), and
-individuals participating in exchanges must be allowed to change from one qualified plan to another outside of open enrollment if certain things occur — like marriage, birth or adoption.
Even though the new rules don’t impact employers directly, companies can use them to determine what they should offer for their plans to be considered competitive when measured against plans offered in an exchange.
http://www.hrmorning.com/new-rules-for-setting-up-health-exchanges/
Hat Tip: HR Morning
New York- Republicans Want Further Study on a Health Exchange
Inaction over the establishment of the Health Insurance Exchange has incited a unified push from many advocacy groups, urging the Senate to stop delaying the bill and bring it to the floor.
Health Care for All New York, a coalition of more than 130 organizations fighting for affordable health care for all New Yorkers, held a conference outside the Senate lobby last Wednesday.
...
Some Republican lawmakers argue that a health exchange, which would require certain conditions of the participating insurance providers, is a step toward nationalized health care and oppose it on principle.
The push for legislative action comes after a bill (S.6699) was issued to further study the need for a New York health exchange. Sens. James Seward, R-Milford, and Kemp Hannon R-Nassau, chairs of the Senate Insurance and Health committees, respectively, put forward the bill March 11 with the intent to further study costs associated with the establishment of an exchange and search for potential alternatives, such as a regional exchange.
Some see the Republican bill as a stall tactic.
According to Health Care for All New York, this bill "indicates a significant retreat by the Senate from the Exchange establishment legislation." The coalition says urgent action is necessary.
http://www.legislativegazette.com/Articles-Top-Stories-c-2012-03-19-81445.113122-Republicans-want-further-study-on-a-health-exchange-Special-interest-groups-say-GOP-senators-are-stalling.html
Hat Tip: Legislative Gazette
Health Care for All New York, a coalition of more than 130 organizations fighting for affordable health care for all New Yorkers, held a conference outside the Senate lobby last Wednesday.
...
Some Republican lawmakers argue that a health exchange, which would require certain conditions of the participating insurance providers, is a step toward nationalized health care and oppose it on principle.
The push for legislative action comes after a bill (S.6699) was issued to further study the need for a New York health exchange. Sens. James Seward, R-Milford, and Kemp Hannon R-Nassau, chairs of the Senate Insurance and Health committees, respectively, put forward the bill March 11 with the intent to further study costs associated with the establishment of an exchange and search for potential alternatives, such as a regional exchange.
Some see the Republican bill as a stall tactic.
According to Health Care for All New York, this bill "indicates a significant retreat by the Senate from the Exchange establishment legislation." The coalition says urgent action is necessary.
http://www.legislativegazette.com/Articles-Top-Stories-c-2012-03-19-81445.113122-Republicans-want-further-study-on-a-health-exchange-Special-interest-groups-say-GOP-senators-are-stalling.html
Hat Tip: Legislative Gazette
Hawaii- Consumer Advocates Lash Out at Governor Appointments to Exchange Board
Railing against a potential conflict of interest, a group of consumer groups and community organizations called for a House committee today to amend a bill to exclude representatives of three health insurers appointed by Gov. Neil Abercrombie to a federally mandated health insurance exchange.
The consumer advocates said during a press conference in the Capitol Rotunda that allowing Hawaii Medical Service Association, Kaiser Permanente Hawaii and Hawaii Dental Service to remain on the 11-member exchange board would be a conflict of interest because they will have a direct financial stake in decisions of the exchange, known as the Hawaii Health Connector. The consumer groups said as many as 100,000 Hawaii residents are currently without health insurance and that the exchange, due to begin in January 2014, would represent a new market valued at an estimated $300 million.
The representative of a fourth health plan provider, Ohana Health Plan, withdrew his name as a nominee today after accepting a position at Kaiser.
Consumer advocates said the alleged conflict would prevent the insurers from acting in the public interest and said that the insurers could be more fairly utilized as technical consultants but not actual members of the board. A hearing on SB2434 was heard today by the House Committee on Consumer Protection and Commerce.
http://www.staradvertiser.com/news/breaking/143424236.html
Hat Tip: Honolulu Star-Advertiser
The consumer advocates said during a press conference in the Capitol Rotunda that allowing Hawaii Medical Service Association, Kaiser Permanente Hawaii and Hawaii Dental Service to remain on the 11-member exchange board would be a conflict of interest because they will have a direct financial stake in decisions of the exchange, known as the Hawaii Health Connector. The consumer groups said as many as 100,000 Hawaii residents are currently without health insurance and that the exchange, due to begin in January 2014, would represent a new market valued at an estimated $300 million.
The representative of a fourth health plan provider, Ohana Health Plan, withdrew his name as a nominee today after accepting a position at Kaiser.
Consumer advocates said the alleged conflict would prevent the insurers from acting in the public interest and said that the insurers could be more fairly utilized as technical consultants but not actual members of the board. A hearing on SB2434 was heard today by the House Committee on Consumer Protection and Commerce.
http://www.staradvertiser.com/news/breaking/143424236.html
Hat Tip: Honolulu Star-Advertiser
Washington- Fledgling Exchange Moves Ahead
Washington state moved closer this week to opening its own online marketplace for consumers to shop for health insurance.
...
Washington's exchange will essentially be a public-private partnership designed to give consumers an easy way to compare the benefits of various plans, said Richard Onizuka, the assistant director of the Health Care Policy Division of the state Health Care Authority. It will be developed and implemented by a board of nine officials from health agencies, the medical industry and other sectors appointed by Gov. Chris Gregoire and two non-voting members.
...
Along with the website, the exchange will perform several functions. It will certify qualified health plans based on federal standards, provide information for consumers about their eligibility for Medicaid and other health programs, and operate a hotline for consumers. It will also run "navigator" programs, systems set up to inform people and assist them in purchasing the best health plan for them.
The exchange will offer several categories of plans. Platinum, the highest-coverage option, will pay for 90 percent of the costs to cover a list of benefits the government considers essential, such as emergency care. Bronze, a lower-coverage option, will pay for 60 percent of the costs. Silver and gold plans will fall between the two. The "essential benefits" covered in each plan include access to prescription drugs, mental health care, hospitalization and maternity care.
Under the new system, catastrophic plans will be offered solely inside the exchange. These plans are only available for low-income consumers age 30 or younger, and they offer a low coverage level.
...
Under the new system, insurance providers will be able to sell plans outside the exchange if they so choose. Concern recently arose at the Insurance Commissioner's Office over the possibility that providers would opt to offer cheaper plans outside the exchange without providing more expensive and options.
http://www.oregonlive.com/politics/index.ssf/2012/03/washingtons_fledgling_health_i.html
Hat Tip: Oregon Live
...
Washington's exchange will essentially be a public-private partnership designed to give consumers an easy way to compare the benefits of various plans, said Richard Onizuka, the assistant director of the Health Care Policy Division of the state Health Care Authority. It will be developed and implemented by a board of nine officials from health agencies, the medical industry and other sectors appointed by Gov. Chris Gregoire and two non-voting members.
...
Along with the website, the exchange will perform several functions. It will certify qualified health plans based on federal standards, provide information for consumers about their eligibility for Medicaid and other health programs, and operate a hotline for consumers. It will also run "navigator" programs, systems set up to inform people and assist them in purchasing the best health plan for them.
The exchange will offer several categories of plans. Platinum, the highest-coverage option, will pay for 90 percent of the costs to cover a list of benefits the government considers essential, such as emergency care. Bronze, a lower-coverage option, will pay for 60 percent of the costs. Silver and gold plans will fall between the two. The "essential benefits" covered in each plan include access to prescription drugs, mental health care, hospitalization and maternity care.
Under the new system, catastrophic plans will be offered solely inside the exchange. These plans are only available for low-income consumers age 30 or younger, and they offer a low coverage level.
...
Under the new system, insurance providers will be able to sell plans outside the exchange if they so choose. Concern recently arose at the Insurance Commissioner's Office over the possibility that providers would opt to offer cheaper plans outside the exchange without providing more expensive and options.
http://www.oregonlive.com/politics/index.ssf/2012/03/washingtons_fledgling_health_i.html
Hat Tip: Oregon Live
Wyoming- Coalition Plans Forum on Health Exchanges
Insurance exchanges are a key part of the federal effort to reform health care, but many employers still don’t understand how they work.
“It’s really a vague, fuzzy notion for most people,” said Anne Ladd, chief executive of the Wyoming Business Coalition on Health.
Ladd wants to change that. She believes the more business owners know about exchanges, the more they’ll like them. That support, in turn, could convince reluctant lawmakers to push forward with a program in Wyoming.
...
A legislative committee has spent more than a year exploring models for a Wyoming exchange. But lawmakers won’t make a final decision on the program until next year - after the U.S. Supreme Court rules on the constitutionality of the federal health reform law.
That won’t leave the state much time to start an exchange before the January 2014 deadline, Ladd said.
Exchanges were popularized by the Heritage Foundation, a conservative think tank. But they are mostly associated with President Barack Obama, who is unpopular in Wyoming.
Because of that connection, some people immediately dismiss the value of exchanges. Opinions change, however, when they learn more about the concept, Ladd said.
“The federal legislation has a few hidden gems in there,” she said.
http://trib.com/news/local/casper/coalition-plans-forum-on-health-exchanges/article_62c174d8-f799-5519-9000-d038dc1acf14.html#ixzz1piEP5fiB
Hat Tip: Casper Tribune
“It’s really a vague, fuzzy notion for most people,” said Anne Ladd, chief executive of the Wyoming Business Coalition on Health.
Ladd wants to change that. She believes the more business owners know about exchanges, the more they’ll like them. That support, in turn, could convince reluctant lawmakers to push forward with a program in Wyoming.
...
A legislative committee has spent more than a year exploring models for a Wyoming exchange. But lawmakers won’t make a final decision on the program until next year - after the U.S. Supreme Court rules on the constitutionality of the federal health reform law.
That won’t leave the state much time to start an exchange before the January 2014 deadline, Ladd said.
Exchanges were popularized by the Heritage Foundation, a conservative think tank. But they are mostly associated with President Barack Obama, who is unpopular in Wyoming.
Because of that connection, some people immediately dismiss the value of exchanges. Opinions change, however, when they learn more about the concept, Ladd said.
“The federal legislation has a few hidden gems in there,” she said.
http://trib.com/news/local/casper/coalition-plans-forum-on-health-exchanges/article_62c174d8-f799-5519-9000-d038dc1acf14.html#ixzz1piEP5fiB
Hat Tip: Casper Tribune
Missouri- Senate Votes Down Health Insurance Exchange
The Missouri Senate has rejected an attempt to set up a state-run health insurance exchange.
...
On Monday, Sen. Joe Keaveny tried to add an amendment setting up the exchanges to a life insurance bill being debated by the Senate. The full Senate rejected the amendment in a voice vote.
Keaveny, a St. Louis Democrat, says his amendment is nearly identical to legislation approved last year by the Republican-controlled House. That bill never came to a vote in the Senate.
http://www.kfvs12.com/story/17203087/mo-senate-votes-down-health-insurance-exchange
Hat Tip: KFVS- CBS News
...
On Monday, Sen. Joe Keaveny tried to add an amendment setting up the exchanges to a life insurance bill being debated by the Senate. The full Senate rejected the amendment in a voice vote.
Keaveny, a St. Louis Democrat, says his amendment is nearly identical to legislation approved last year by the Republican-controlled House. That bill never came to a vote in the Senate.
http://www.kfvs12.com/story/17203087/mo-senate-votes-down-health-insurance-exchange
Hat Tip: KFVS- CBS News
National- Why Aren’t State Exchanges Embracing Prudent Purchasing Strategies?
In the design of health insurance exchanges, one key issue is whether exchanges will offer improved value to people buying insurance in the individual and small group markets. A lot depends on whether the exchanges act as prudent purchasers – making design decisions that keep quality high and costs low. It appears that many states, however, are pursuing a different approach – one that allows virtually any licensed insurance carrier to participate and does not use effective purchasing strategies that are widely used by large employers. If this approach is used, we will have missed an opportunity to reduce costs and improve quality for exchange participants.
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Why are most state exchanges not pursuing a prudent purchaser strategy? One reason, of course, is that some health insurers and provider organizations have expressed opposition. These groups often have significant political influence, and they have been successful in some states in getting legislation that prohibits the exchanges from being active purchasers. There is, however, a deeper explanation for the fact that most state exchanges are not pursuing prudent purchaser strategies. In the exchanges, the premiums are paid by participating individuals and small employers, and the subsidies for low-income individuals are paid by the federal government.
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Shouldn’t something be done to encourage states to use prudent purchasing strategies? Surely it would be better for the exchange’s beneficiaries – individuals and small employers – if the exchange were able to offer lower costs and better quality. In addition, an exchange’s efforts to improve affordability and quality could be a catalyst for broader improvement throughout the health care system. From the federal government’s perspective, an exchange acting as a prudent purchaser would help to keep the cost of government subsidies lower.
http://healthaffairs.org/blog/2012/03/19/why-arent-state-exchanges-embracing-prudent-purchasing-strategies/
Hat Tip: Health Affairs, Health Affairs Blog, William Kramer
...
Why are most state exchanges not pursuing a prudent purchaser strategy? One reason, of course, is that some health insurers and provider organizations have expressed opposition. These groups often have significant political influence, and they have been successful in some states in getting legislation that prohibits the exchanges from being active purchasers. There is, however, a deeper explanation for the fact that most state exchanges are not pursuing prudent purchaser strategies. In the exchanges, the premiums are paid by participating individuals and small employers, and the subsidies for low-income individuals are paid by the federal government.
...
Shouldn’t something be done to encourage states to use prudent purchasing strategies? Surely it would be better for the exchange’s beneficiaries – individuals and small employers – if the exchange were able to offer lower costs and better quality. In addition, an exchange’s efforts to improve affordability and quality could be a catalyst for broader improvement throughout the health care system. From the federal government’s perspective, an exchange acting as a prudent purchaser would help to keep the cost of government subsidies lower.
http://healthaffairs.org/blog/2012/03/19/why-arent-state-exchanges-embracing-prudent-purchasing-strategies/
Hat Tip: Health Affairs, Health Affairs Blog, William Kramer
National- Building a Better Health Insurance Exchange
It’s no exaggeration to describe the health insurance exchanges as the health reform law’s backbone: For the 32 million Americans expected to gain health insurance, these state-based, marketplaces will likely be their first point of contact with the Affordable Care Act.
...
The White House does give states some flexibility in setting standards for their marketplaces. They get to decide who runs the new market and which insurance companies get to participate. They can outsource some functions that they don’t have capabilities for to the federal government.
At the end of the day though, it’s the White House that will determine if a state’s health insurance exchange is up to snuff. The new marketplaces will launch on Jan. 1, 2014. But a year prior, in 2013, Health and Human Services will certify which exchanges are - and aren’t - able to deliver the customer experience that the White House wants to see. That includes things like allowing consumers to easily compare plans and having an enrollment mechanism for both private insurance and Medicaid. States will have to summarize these developments next year in what the administration has now dubbed an “Exchange blueprint” before getting the go-ahead.
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“The regulations issued today by the Department of Health and Human Services extend the federal government’s reach into the states and will cost the states millions of dollars annually to operate,” Republican Governors Association president Bob McDonnell, Virginia’s governor, said in a statement.
But, for the Obama administration, there’s a strong interest in ensuring that the health reform law looks a lot like what the law envisions: These exchanges are the main tool for expanding insurance to millions of Americans. So in walking a tightrope between stringent standards and state flexibility, the administration has leaned slightly towards the former.
http://www.washingtonpost.com/blogs/ezra-klein/post/building-a-better-health-insurance-exchange/2012/03/12/gIQA3tez7R_blog.html
Hat Tip: Washington Post, Wonkblog, Sarah Kliff
...
The White House does give states some flexibility in setting standards for their marketplaces. They get to decide who runs the new market and which insurance companies get to participate. They can outsource some functions that they don’t have capabilities for to the federal government.
At the end of the day though, it’s the White House that will determine if a state’s health insurance exchange is up to snuff. The new marketplaces will launch on Jan. 1, 2014. But a year prior, in 2013, Health and Human Services will certify which exchanges are - and aren’t - able to deliver the customer experience that the White House wants to see. That includes things like allowing consumers to easily compare plans and having an enrollment mechanism for both private insurance and Medicaid. States will have to summarize these developments next year in what the administration has now dubbed an “Exchange blueprint” before getting the go-ahead.
...
“The regulations issued today by the Department of Health and Human Services extend the federal government’s reach into the states and will cost the states millions of dollars annually to operate,” Republican Governors Association president Bob McDonnell, Virginia’s governor, said in a statement.
But, for the Obama administration, there’s a strong interest in ensuring that the health reform law looks a lot like what the law envisions: These exchanges are the main tool for expanding insurance to millions of Americans. So in walking a tightrope between stringent standards and state flexibility, the administration has leaned slightly towards the former.
http://www.washingtonpost.com/blogs/ezra-klein/post/building-a-better-health-insurance-exchange/2012/03/12/gIQA3tez7R_blog.html
Hat Tip: Washington Post, Wonkblog, Sarah Kliff
Monday, March 19, 2012
Connecticut- Without Federal Law, Some Pieces of Health Reform Could Continue in Connecticut
Connecticut officials are working to create a new health insurance market that will open next year, hire a CEO to run it and prepare for an influx of new Medicaid recipients by 2014.
In effect, they're racing to implement a law that might not exist for long, at least in its current form.
But those involved in putting federal health reform into action say that Connecticut isn't likely to stop moving forward on a major piece of the act, regardless of how the law fares before the U.S. Supreme Court or under a new Congress after this fall's elections.
"I think if there were to be some major change, such as the [act] was rendered unconstitutional and therefore removed, that we would be far enough along down the line that we would have a lot of what we need in place," said Jeannette DeJesús, special adviser to the governor for health reform.
In particular, the creation of a marketplace for buying insurance coverage, known as a health insurance exchange, could happen even if the federal law is altered substantially, those planning the state's exchange say. Connecticut has already received more than $7 million in federal funds to develop the exchange, and is expected to have applied for most or all necessary federal start-up money by June, when the Supreme Court ruling is expected.
http://www.ctmirror.org/story/15733/without-federal-law-some-pieces-health-reform-could-continue-connecticut
Hat Tip: Connecticut Mirror
In effect, they're racing to implement a law that might not exist for long, at least in its current form.
But those involved in putting federal health reform into action say that Connecticut isn't likely to stop moving forward on a major piece of the act, regardless of how the law fares before the U.S. Supreme Court or under a new Congress after this fall's elections.
"I think if there were to be some major change, such as the [act] was rendered unconstitutional and therefore removed, that we would be far enough along down the line that we would have a lot of what we need in place," said Jeannette DeJesús, special adviser to the governor for health reform.
In particular, the creation of a marketplace for buying insurance coverage, known as a health insurance exchange, could happen even if the federal law is altered substantially, those planning the state's exchange say. Connecticut has already received more than $7 million in federal funds to develop the exchange, and is expected to have applied for most or all necessary federal start-up money by June, when the Supreme Court ruling is expected.
http://www.ctmirror.org/story/15733/without-federal-law-some-pieces-health-reform-could-continue-connecticut
Hat Tip: Connecticut Mirror
Oklahoma-More States Join Oklahoma in Delaying Action on Health Insurance Exchange
At least 14 other states have joined Oklahoma in delaying legislative consideration of health insurance exchanges until after the U.S. Supreme Court rules on the constitutionality of the Affordable Care Act.
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The Center on Budget and Policy Priorities tracks progress of states toward the federal exchange mandate.
Along with Oklahoma, Alabama, Alaska, Florida, Georgia, Indiana, Kansas, Maine, Michigan, Missouri, Nebraska, South Dakota, Texas, Virginia and Wisconsin reportedly have decided to put off any moves on the issue until after the Supreme Court rules, the center's latest report shows.
Only 11 states have established authority for a state exchange, according to the center's tally. Seven other states have legislation pending on the issue.
While legislation isn't the only way for an exchange to be established - Rhode Island did so by a governor's order, and Mississippi is working on an exchange set up by that state's insurance commissioner - it is the most common way.
Sen. Gary Stanislawski, R-Tulsa, said he wasn't aware of the number of states waiting on the Supreme Court, but he said the high number certainly bolsters Oklahoma's choice.
State GOP leaders hope either the Supreme Court or the upcoming national elections will make the issue moot, but if neither of those things happen, Stanislawski thinks it will be time for the Legislature to act.
http://www.tulsaworld.com/news/article.aspx?subjectid=336&articleid=20120319_16_A1_CUTLIN221
Hat Tip: Tulsa World
National- HHS Issues Final Rule to Implement Health Insurance Exchange Markets
The Department of Health and Human Services March 12 issued a final rule implementing a key component of the Patient Protection and Affordable Care Act—creation of health insurance exchange markets in all states in 2014 through which millions of individuals and small businesses can buy coverage and receive premium assistance subsidies.
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The final rule combines two exchange rules proposed in 2011 under PPACA. An “establishment” proposed rule, published July 15, 2011, outlined a framework for states to build their exchanges. Another proposed rule, published Aug. 17, 2011, included standards for eligibility and enrollment in health plans, which must be certified as “qualified health plans” to be offered in the exchanges; as well as standards for tax credit premium and cost-sharing subsidies for low- and moderate-income individuals (29 HRR 880, 8/15/11).
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Although the final rule has a more immediate impact on individuals and small businesses, it also has implications for large employers, human resources and public policy experts told Bloomberg BNA.
“This matters to large employers in a less explicit manner, but it is important because states will have the option of opening their exchanges in 2017 to large employers,” Shawn Nowicki, director of public policy at HealthPass, told Bloomberg BNA March 15. HealthPass is a commercial, private health insurance exchange that works with small businesses in the New York area.
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According to Chiquita Brooks-LaSure, director of coverage policy in HHS's Office of Health Reform, the most significant change in the final rule from the proposed rule is that it allows additional flexibility for states regarding eligibility determinations. She said the final rule codified guidance issued by HHS in November 2011. More than 24,000 comments were filed on the proposed rule, Hill said.
Changes made to the proposed rule also allow states to determine a role for agents and brokers, including the use of online brokers, Hill said.
http://www.bna.com/hhs-issues-final-n12884908407/
Hat Tip: Bloomberg News BNA
...
The final rule combines two exchange rules proposed in 2011 under PPACA. An “establishment” proposed rule, published July 15, 2011, outlined a framework for states to build their exchanges. Another proposed rule, published Aug. 17, 2011, included standards for eligibility and enrollment in health plans, which must be certified as “qualified health plans” to be offered in the exchanges; as well as standards for tax credit premium and cost-sharing subsidies for low- and moderate-income individuals (29 HRR 880, 8/15/11).
...
Although the final rule has a more immediate impact on individuals and small businesses, it also has implications for large employers, human resources and public policy experts told Bloomberg BNA.
“This matters to large employers in a less explicit manner, but it is important because states will have the option of opening their exchanges in 2017 to large employers,” Shawn Nowicki, director of public policy at HealthPass, told Bloomberg BNA March 15. HealthPass is a commercial, private health insurance exchange that works with small businesses in the New York area.
...
According to Chiquita Brooks-LaSure, director of coverage policy in HHS's Office of Health Reform, the most significant change in the final rule from the proposed rule is that it allows additional flexibility for states regarding eligibility determinations. She said the final rule codified guidance issued by HHS in November 2011. More than 24,000 comments were filed on the proposed rule, Hill said.
Changes made to the proposed rule also allow states to determine a role for agents and brokers, including the use of online brokers, Hill said.
http://www.bna.com/hhs-issues-final-n12884908407/
Hat Tip: Bloomberg News BNA
Thursday, March 8, 2012
Tennessee- Insurance Exchanges Explained
Health insurance exchanges are critical components of the 2010 Affordable Care Act.
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Tennessee is one of seven states (Idaho, South Dakota, Nebraska, Kansas, Kentucky, and Delaware are the others) that have not passed enabling legislation. Our state has obtained some federal funding to begin the planning of an exchange. Governors of South Carolina, Florida, Louisiana, and New Mexico have vetoed legislation that would permit the establishment of exchanges in their states.
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Through the experiences of patients, I have seen health insurance plans in the past that bordered on fraud. Through convoluted language these plans set lifetime limits on coverage. Minor health issues in childhood could be resurrected to block payments for adult illnesses. Coverage for cancers and other catastrophic illnesses could be canceled in midtreatment. These practices are banned by the ACA and the exchanges established under the legislation.
Most states are well along in preparing for exchanges. Those states that are not assume either that the Supreme Court will rule the ACA unconstitutional or that a new Congress will repeal it. I think this plays roulette with the health of citizens of those states, including Tennessee.
Competition in health care succeeds when consumers are given readily understandable facts that allow them to make informed choices. A state-based exchange is the eminently sensible way to achieve this goal.
http://timesfreepress.com/news/2012/mar/08/insurance-exchanges-explained/
Hat Tip: Chattanooga Times Free Press
...
Tennessee is one of seven states (Idaho, South Dakota, Nebraska, Kansas, Kentucky, and Delaware are the others) that have not passed enabling legislation. Our state has obtained some federal funding to begin the planning of an exchange. Governors of South Carolina, Florida, Louisiana, and New Mexico have vetoed legislation that would permit the establishment of exchanges in their states.
...
Through the experiences of patients, I have seen health insurance plans in the past that bordered on fraud. Through convoluted language these plans set lifetime limits on coverage. Minor health issues in childhood could be resurrected to block payments for adult illnesses. Coverage for cancers and other catastrophic illnesses could be canceled in midtreatment. These practices are banned by the ACA and the exchanges established under the legislation.
Most states are well along in preparing for exchanges. Those states that are not assume either that the Supreme Court will rule the ACA unconstitutional or that a new Congress will repeal it. I think this plays roulette with the health of citizens of those states, including Tennessee.
Competition in health care succeeds when consumers are given readily understandable facts that allow them to make informed choices. A state-based exchange is the eminently sensible way to achieve this goal.
http://timesfreepress.com/news/2012/mar/08/insurance-exchanges-explained/
Hat Tip: Chattanooga Times Free Press
New Hampshire- House Republicans Reject Required Health Care Exchange
The House of Representatives met the desires of House Speaker William O’Brien, R-Mont Vernon and Republican leaders to defy requirements of states under the federal health care law.
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By a party-line vote, the House endorsed an amendment O’Brien authored, HB 1297, to not only refuse to create a state exchange, but also to prevent Insurance Commissioner Roger Sevigny from cooperating with the Obama administration to set up a federal one.
The final vote was 219-94.
Rep. Donna Schlachman, Exeter-D had argued that states need to do planning now.
“This legislation is about wishful thinking and political posturing; it is not about being prepared,” Schlachman said.
During his state of the state speech, Lynch forcefully called upon the state to pass a bill creating a health care exchange.
...
Schlachman said the bill was counterproductive because the national law mandates that the federal government is to move in and set up exchanges in states that lack their own.
“Rather than make decisions for our state, House Republicans are passing the buck on to the federal government and failing to meet their responsibilities,” Schlachman said. “Businesses and families can’t just assume something is going to happen – they need to be prepared for contingencies.”
A large coalition of business groups are supporting state health exchanges including the Greater Nashua Chamber of Commerce, Business & Industry Association, auto dealers, ski resort owners along with the major insurance companies in the state.
The state Senate has already failed once to support state health exchanges.
http://www.nashuatelegraph.com/newsstatenewengland/952891-227/house-republicans-reject-required-health-care-exchange.html
Hat Tip: Nashua Telegraph
...
By a party-line vote, the House endorsed an amendment O’Brien authored, HB 1297, to not only refuse to create a state exchange, but also to prevent Insurance Commissioner Roger Sevigny from cooperating with the Obama administration to set up a federal one.
The final vote was 219-94.
Rep. Donna Schlachman, Exeter-D had argued that states need to do planning now.
“This legislation is about wishful thinking and political posturing; it is not about being prepared,” Schlachman said.
During his state of the state speech, Lynch forcefully called upon the state to pass a bill creating a health care exchange.
...
Schlachman said the bill was counterproductive because the national law mandates that the federal government is to move in and set up exchanges in states that lack their own.
“Rather than make decisions for our state, House Republicans are passing the buck on to the federal government and failing to meet their responsibilities,” Schlachman said. “Businesses and families can’t just assume something is going to happen – they need to be prepared for contingencies.”
A large coalition of business groups are supporting state health exchanges including the Greater Nashua Chamber of Commerce, Business & Industry Association, auto dealers, ski resort owners along with the major insurance companies in the state.
The state Senate has already failed once to support state health exchanges.
http://www.nashuatelegraph.com/newsstatenewengland/952891-227/house-republicans-reject-required-health-care-exchange.html
Hat Tip: Nashua Telegraph
Oregon- Q&A: Gov. Kitzhaber Signs Health Insurance Exchange
Governor John Kitzhaber signed Oregon's new Health Insurance Exchange into law today. Kristian Foden-Vencil was at the signing in Portland he’s with me now.
Good afternoon Kristian.
Kristian: Hi. Beth: The Health Insurance Exchange is one of the Governor's key health policies -- both for the 2012 legislature and for his third term in office. Can you remind us what the 'Health Insurance Exchange' is?
Kristian: Yes. Essentially, President Obama's health care reform asks states to set up their own health insurance exchanges.
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Beth: What did the governor say as he signed it into law?
Kristian: Well he called it a great day for Oregon. He said the exchange is going to provide significant benefits to small businesses and individuals. It's going to allow people to compare the quality and cost of insurance plans. And, he says it's going to be a great resource for Oregonians:
John Kitzhaber: "It is going to be a central contributor to the success of our larger health care reform effort, by setting the setting the standards for plans that they reduce cost, that they maintain quality and that everyone has access to the kind of coverage that they need and deserve in this state."
http://news.opb.org/article/q-kitzhaber-signs-health-insurance-exchange/
Hat Tip: Oregon Public Broadcasting
Good afternoon Kristian.
Kristian: Hi. Beth: The Health Insurance Exchange is one of the Governor's key health policies -- both for the 2012 legislature and for his third term in office. Can you remind us what the 'Health Insurance Exchange' is?
Kristian: Yes. Essentially, President Obama's health care reform asks states to set up their own health insurance exchanges.
...
Beth: What did the governor say as he signed it into law?
Kristian: Well he called it a great day for Oregon. He said the exchange is going to provide significant benefits to small businesses and individuals. It's going to allow people to compare the quality and cost of insurance plans. And, he says it's going to be a great resource for Oregonians:
John Kitzhaber: "It is going to be a central contributor to the success of our larger health care reform effort, by setting the setting the standards for plans that they reduce cost, that they maintain quality and that everyone has access to the kind of coverage that they need and deserve in this state."
http://news.opb.org/article/q-kitzhaber-signs-health-insurance-exchange/
Hat Tip: Oregon Public Broadcasting
Wednesday, March 7, 2012
CO-OPs- Nebraska: Health Care CO-OP Could Benefit
The Obama administration last month announced that it would bankroll formation of a nonprofit health care cooperative, similar to the farm co-ops familiar in rural states, to serve Nebraska and Iowa.
Midwest Members Health would give consumers something unusual in these parts -- welcome competition for the giant companies that dominate the market.
The American Medical Association last year ranked Nebraska the sixth least competitive market among the states.
The new cooperative is Iowa-centric in that its leaders are based in Iowa. Heading the new venture are former Iowa state insurance commissioner David Lyons, Cliff Gold, a former executive at Wellmark Blue Cross Blue Shield in Iowa, and Iowa venture capitalist Steve Ringlee.
The new co-op won a loan for $112,612,100 out of $640 million awarded to six plans for co-ops. Other states to be served by the new co-ops are Montana, New Jersey, New Mexico, New York, Oregon and Wisconsin.
The concept proposed by Midwest Members Health is particularly promising in several aspects.
Most importantly, the new co-op plans to utilize Midlands Choice, an existing network of doctors and hospitals, rather than embarking on the massive task of trying to create its own provider network. Midlands Choice already has contracts with all hospitals in Nebraska and Iowa, and 90 percent of physicians.
...
Past efforts to set up health co-operatives do not inspire confidence. Attempts in the 1990s to set up health cooperatives in Florida, Texas and Colorado were unsuccessful. The Government Accountability Office said in 2000 that small cooperatives did not have enough leverage to provide savings for consumers.
The Obama administration, in fact, predicted itself that 40 percent of the loans it just issued to set up new health insurance co-ops would not be repaid.
Lyons said that if the nonprofit insurance co-op couldn't work in Iowa and Nebraska, it probably wouldn't work anywhere. That may not be the most glowing endorsement one could make for the concept, but it has the ring of truth.
http://journalstar.com/news/opinion/editorial/columnists/editorial-health-care-co-op-could-benefit/article_7fc03a20-37f0-52b8-ad21-13536b93d9fa.html
Hat Tip: Lincoln Journal-Star
Midwest Members Health would give consumers something unusual in these parts -- welcome competition for the giant companies that dominate the market.
The American Medical Association last year ranked Nebraska the sixth least competitive market among the states.
The new cooperative is Iowa-centric in that its leaders are based in Iowa. Heading the new venture are former Iowa state insurance commissioner David Lyons, Cliff Gold, a former executive at Wellmark Blue Cross Blue Shield in Iowa, and Iowa venture capitalist Steve Ringlee.
The new co-op won a loan for $112,612,100 out of $640 million awarded to six plans for co-ops. Other states to be served by the new co-ops are Montana, New Jersey, New Mexico, New York, Oregon and Wisconsin.
The concept proposed by Midwest Members Health is particularly promising in several aspects.
Most importantly, the new co-op plans to utilize Midlands Choice, an existing network of doctors and hospitals, rather than embarking on the massive task of trying to create its own provider network. Midlands Choice already has contracts with all hospitals in Nebraska and Iowa, and 90 percent of physicians.
...
Past efforts to set up health co-operatives do not inspire confidence. Attempts in the 1990s to set up health cooperatives in Florida, Texas and Colorado were unsuccessful. The Government Accountability Office said in 2000 that small cooperatives did not have enough leverage to provide savings for consumers.
The Obama administration, in fact, predicted itself that 40 percent of the loans it just issued to set up new health insurance co-ops would not be repaid.
Lyons said that if the nonprofit insurance co-op couldn't work in Iowa and Nebraska, it probably wouldn't work anywhere. That may not be the most glowing endorsement one could make for the concept, but it has the ring of truth.
http://journalstar.com/news/opinion/editorial/columnists/editorial-health-care-co-op-could-benefit/article_7fc03a20-37f0-52b8-ad21-13536b93d9fa.html
Hat Tip: Lincoln Journal-Star
Oregon- Will Tax Health Plans to Fund Exchange
Oregon political leaders decided last year to create the health insurance exchange mandated under President Obama’s health care law. But they have since run into a series of hurdles which illustrate the difficulty of timely implementation, including a decision to tax health plans to fund the exchange after federal grant money runs out and the challenge of deciding which benefits will be mandatory under insurance plans.
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The business plan for Oregon’s exchange, HB 4164, is currently under consideration in the state legislature. Lawmakers established a public corporation last year to create the exchange, and decided to allow for up to a 5 percent tax on health care plans sold under the exchange in order to pay for it. The business plan assumes a tax of 2.5 percent in 2014 and 2.7 percent in 2015.
http://news.heartland.org/newspaper-article/2012/03/07/oregon-will-tax-health-plans-fund-exchange
Hat Tip: The Heartland.Org
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The business plan for Oregon’s exchange, HB 4164, is currently under consideration in the state legislature. Lawmakers established a public corporation last year to create the exchange, and decided to allow for up to a 5 percent tax on health care plans sold under the exchange in order to pay for it. The business plan assumes a tax of 2.5 percent in 2014 and 2.7 percent in 2015.
http://news.heartland.org/newspaper-article/2012/03/07/oregon-will-tax-health-plans-fund-exchange
Hat Tip: The Heartland.Org
New Hampshire- House Readies Vote on Health Exchange
A bill prohibiting state officials from planning for a state health exchange is one of the major measures affecting business that is due to come before the House this week.
The bill is expected to be voted on either Wednesday or Thursday, as the House moves toward its deadline for bills that don't go to a second committee.
...
They're also concerned that a federal exchange would shut out the local insurance industry and even regional health insurers.
Those supporting House Bill 1297 (which was approved by a 10-6 majority of the House Commerce Committee) maintain that a state exchange still has to follow federal rules so it makes no difference, and if enough states don't cooperate, then ACA will end up failing.
http://www.nhbr.com/businessnewsstatenews/952556-257/house-readies-vote-on-health-exchange.html
Hat Tip: New Hampshire Business Review
The bill is expected to be voted on either Wednesday or Thursday, as the House moves toward its deadline for bills that don't go to a second committee.
...
They're also concerned that a federal exchange would shut out the local insurance industry and even regional health insurers.
Those supporting House Bill 1297 (which was approved by a 10-6 majority of the House Commerce Committee) maintain that a state exchange still has to follow federal rules so it makes no difference, and if enough states don't cooperate, then ACA will end up failing.
http://www.nhbr.com/businessnewsstatenews/952556-257/house-readies-vote-on-health-exchange.html
Hat Tip: New Hampshire Business Review
CO-OPs- New York: Union Clinic to be Model for Freelancer Care
As soon as this summer, the Freelancers Union plans to open a health clinic in Brooklyn which could eventually serve up to 100,000 self-employed New Yorkers. Yesterday, as part of an effort to bolster that plan, as well as pay homage to the union that inspired it, Council Speaker Christine Quinn toured a Hotel Trades Council-run health clinic.
...
To aid the union with its plan, the City Council recently set aside $100,000 to go toward a flagship health center in Brooklyn. Freelancers Union founder Sara Horowitz said they’re still looking for space in Downtown Brooklyn, but they’ve already signed on Cambridge-based Iora Health to manage the facility. Iora is a for-profit company that has two clinics that serve restaurant workers in Las Vegas and another in New Hampshire for Dartmouth College employees.
Initially, the Freelancers’ Union, which has 93,000 members in the city, will support 3,000 people in the walk-in clinics. But according to the plan, it will eventually support as many as 100,000 patients enrolled in the Freelancers Insurance Company. Aside from having primary care and other specialized medical services, Horowitz said they’re also looking at alternative medicine and yoga.
...
In a seperate initiative, the Freelancers Union last month got a $340 million federal grant to create Consumer Operated and Oriented Plans (CO-OPs) in New York, New Jersey and Oregon. Of that, $174 million will go to New York's plan. (The money comes from $3.8 billion in co-op funding set aside for in the 2010 national health care legislation.)
The freelancer co-ops would be independently run plans with their own leadership, but sponsored by the union. They would compete with private insurers and launch in 2014.
Horowitz pointed out that New York was the place where experiments in health, banks and insurance began.
http://www.capitalnewyork.com/article/politics/2012/03/5406676/quinn-tours-union-health-clinic-she-hopes-will-be-model-freelancer-
Hat Tip: Capital New York
...
To aid the union with its plan, the City Council recently set aside $100,000 to go toward a flagship health center in Brooklyn. Freelancers Union founder Sara Horowitz said they’re still looking for space in Downtown Brooklyn, but they’ve already signed on Cambridge-based Iora Health to manage the facility. Iora is a for-profit company that has two clinics that serve restaurant workers in Las Vegas and another in New Hampshire for Dartmouth College employees.
Initially, the Freelancers’ Union, which has 93,000 members in the city, will support 3,000 people in the walk-in clinics. But according to the plan, it will eventually support as many as 100,000 patients enrolled in the Freelancers Insurance Company. Aside from having primary care and other specialized medical services, Horowitz said they’re also looking at alternative medicine and yoga.
...
In a seperate initiative, the Freelancers Union last month got a $340 million federal grant to create Consumer Operated and Oriented Plans (CO-OPs) in New York, New Jersey and Oregon. Of that, $174 million will go to New York's plan. (The money comes from $3.8 billion in co-op funding set aside for in the 2010 national health care legislation.)
The freelancer co-ops would be independently run plans with their own leadership, but sponsored by the union. They would compete with private insurers and launch in 2014.
Horowitz pointed out that New York was the place where experiments in health, banks and insurance began.
http://www.capitalnewyork.com/article/politics/2012/03/5406676/quinn-tours-union-health-clinic-she-hopes-will-be-model-freelancer-
Hat Tip: Capital New York
Tuesday, March 6, 2012
National- Exchange Rule Coming ‘Very Soon’: Tavenner
Acting CMS Administrator Marilyn Tavenner told attendees at the Federation of American Hospitals meeting they can expect more information on the state insurance exchanges in the weeks ahead.
“We will need your help as we go into 2012 and into 2013 on setting up the exchanges,” Tavenner said in her morning remarks Tuesday at the Marriott Washington Wardman Park. “And we will have more detail on that as the year rolls out—and, in fact, we will have some details in the next couple of weeks as it relates to the exchanges and Medicaid expansion.”
When asked later if she had been referring to a final rule on the exchanges, Tavenner told Modern Healthcare that the rule would be out “soon.” When pressed if “soon” meant this quarter, the former nurse and HCA executive said “very soon.”
http://www.modernhealthcare.com/article/20120306/NEWS/303069969/exchange-rule-coming-very-soon-tavenner
Hat Tip: Modern Healthcare
“We will need your help as we go into 2012 and into 2013 on setting up the exchanges,” Tavenner said in her morning remarks Tuesday at the Marriott Washington Wardman Park. “And we will have more detail on that as the year rolls out—and, in fact, we will have some details in the next couple of weeks as it relates to the exchanges and Medicaid expansion.”
When asked later if she had been referring to a final rule on the exchanges, Tavenner told Modern Healthcare that the rule would be out “soon.” When pressed if “soon” meant this quarter, the former nurse and HCA executive said “very soon.”
http://www.modernhealthcare.com/article/20120306/NEWS/303069969/exchange-rule-coming-very-soon-tavenner
Hat Tip: Modern Healthcare
Wyoming- House Passes Health Insurance Exchange Bill
The Wyoming House passed a bill Tuesday to continue the study of a health insurance exchange for the state on a 50-8 roll call vote.
The bill, which previously passed the Senate, continues the steering committee study of an exchange for Wyoming and requires a report to the Legislature by October 1.
The bill also adds to the committee one member each from the Araphoe and Shoshone Indian tribes who are residents of the Wind River Indian Reservation.
Gov. Matt Mead supports the steering committee's preliminary recommendation of a state-run insurance exchange.
http://trib.com/news/state-and-regional/govt-and-politics/wyoming-house-passes-health-insurance-exchange-bill/article_54946dbe-6c7e-51f3-9d8e-af9bc1c00e08.html#ixzz1oOeumv17
Hat Tip: Casper Star-Tribune
The bill, which previously passed the Senate, continues the steering committee study of an exchange for Wyoming and requires a report to the Legislature by October 1.
The bill also adds to the committee one member each from the Araphoe and Shoshone Indian tribes who are residents of the Wind River Indian Reservation.
Gov. Matt Mead supports the steering committee's preliminary recommendation of a state-run insurance exchange.
http://trib.com/news/state-and-regional/govt-and-politics/wyoming-house-passes-health-insurance-exchange-bill/article_54946dbe-6c7e-51f3-9d8e-af9bc1c00e08.html#ixzz1oOeumv17
Hat Tip: Casper Star-Tribune
Idaho- Health Insurance Exchange Won't Happen, Legislative Leaders Say
Leaders of the Idaho Legislature said Tuesday that hopes for a bill to create an Idaho-run health insurance exchange are all but dead for this session, setting the stage for Idaho to get a federally run exchange in 2014.
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A state legislative task force passed an early framework for an Idaho exchange, but the draft bill didn't get enough momentum to advance in the House or Senate. The plan would have created a state-run portal for insurance buying and selling, without going as far as some states have by picking which insurers can compete for business.
Gov. Butch Otter's administration got Idaho a $20.3 million federal grant to start building a state exchange. Opposition to the 2010 health care reform law has stifled plans to spend the grant, which was meant to help Idaho meet a Jan. 1, 2013 federal deadline to shape its exchange plans and get them a federal stamp of approval.
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Senate President Pro Tem Brent Hill, R-Rexburg, said he'd thought at the beginning of this year's session that "if anything would keep us here" longer than expected, it would have been a health insurance exchange.
http://www.idahostatesman.com/2012/03/06/2023701/idaho-run-health-insurance-exchange.html
Hat tip: Idaho Statesman
...
A state legislative task force passed an early framework for an Idaho exchange, but the draft bill didn't get enough momentum to advance in the House or Senate. The plan would have created a state-run portal for insurance buying and selling, without going as far as some states have by picking which insurers can compete for business.
Gov. Butch Otter's administration got Idaho a $20.3 million federal grant to start building a state exchange. Opposition to the 2010 health care reform law has stifled plans to spend the grant, which was meant to help Idaho meet a Jan. 1, 2013 federal deadline to shape its exchange plans and get them a federal stamp of approval.
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Senate President Pro Tem Brent Hill, R-Rexburg, said he'd thought at the beginning of this year's session that "if anything would keep us here" longer than expected, it would have been a health insurance exchange.
http://www.idahostatesman.com/2012/03/06/2023701/idaho-run-health-insurance-exchange.html
Hat tip: Idaho Statesman
Washington- Lawmakers Pass Rules for Insurance Exchange
The Washington state Legislature has passed a bill setting rules for insurers preparing for the state's online insurance exchange.
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Under the bill passed Saturday, carriers in Washington will be able to sell plans outside of the exchange, but, as is the case in the exchange, they won't be allowed to offer cheaper "bronze" plans without also selling "silver" and "gold" plans. In this way, they won't be able to opt out of the exchange to cover only the young and the healthy.
"Our concern was that the insurance companies not game the system and operate outside the exchange," said Stephanie Marquis, spokeswoman for the state's Insurance Commissioner's Office. "We got a really good bill passed."
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Catastrophic plans, available to younger people of limited means, would be available only inside the exchange.
The bill also stipulates that the state will use its largest small group insurance plan — currently the Regence BlueShield Innova plan — as its benchmark plan for determining its essential benefits.
http://www.cbsnews.com/8301-505245_162-57391330/wash-lawmakers-pass-rules-for-insurance-exchange/
Hat Tip: CBS News
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Under the bill passed Saturday, carriers in Washington will be able to sell plans outside of the exchange, but, as is the case in the exchange, they won't be allowed to offer cheaper "bronze" plans without also selling "silver" and "gold" plans. In this way, they won't be able to opt out of the exchange to cover only the young and the healthy.
"Our concern was that the insurance companies not game the system and operate outside the exchange," said Stephanie Marquis, spokeswoman for the state's Insurance Commissioner's Office. "We got a really good bill passed."
...
Catastrophic plans, available to younger people of limited means, would be available only inside the exchange.
The bill also stipulates that the state will use its largest small group insurance plan — currently the Regence BlueShield Innova plan — as its benchmark plan for determining its essential benefits.
http://www.cbsnews.com/8301-505245_162-57391330/wash-lawmakers-pass-rules-for-insurance-exchange/
Hat Tip: CBS News
Minnesota- Health Exchange Debate Takes Shape
The terms of debate over health exchanges in Minnesota became a little clearer Monday as Republicans in the state Legislature announced a bill to develop what they described as a free-market alternative to plans from the administration of Democratic Gov. Mark Dayton.
The bill would give individuals access to personal health premium accounts where they could amass funds from a variety of sources to buy health care coverage.
As such, the legislation might help spread insurance coverage to more people with part-time jobs - one of the key groups in the state that currently lacks access to coverage, said Rep. Steve Gottwalt, a Republican from St. Cloud who is sponsoring the bill in the House.
But it's unclear how the idea will be received by Dayton or if it would be sufficient to win certification by the federal government, which by year's end will evaluate the state's planning for a health exchange in Minnesota.
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"This is not a health exchange," said Sen. David Hann, a Republican from Eden Prairie who is sponsoring the bill in the Senate. "We're just creating a financial instrument...by which people who currently are not insured can be insured."
http://www.twincities.com/allheadlines/ci_20105454
Hat Tip: Pioneer Press
The bill would give individuals access to personal health premium accounts where they could amass funds from a variety of sources to buy health care coverage.
As such, the legislation might help spread insurance coverage to more people with part-time jobs - one of the key groups in the state that currently lacks access to coverage, said Rep. Steve Gottwalt, a Republican from St. Cloud who is sponsoring the bill in the House.
But it's unclear how the idea will be received by Dayton or if it would be sufficient to win certification by the federal government, which by year's end will evaluate the state's planning for a health exchange in Minnesota.
...
"This is not a health exchange," said Sen. David Hann, a Republican from Eden Prairie who is sponsoring the bill in the Senate. "We're just creating a financial instrument...by which people who currently are not insured can be insured."
http://www.twincities.com/allheadlines/ci_20105454
Hat Tip: Pioneer Press
Monday, March 5, 2012
Ohio- Obama Official Puzzled by Ohio's Inaction On Exchange
Count the region’s U.S. Health and Human Services director among those wondering when Ohio will make a decision on whether it’s going to operate its own health insurance exchange under federal health reform.
Kenneth Munson, HHS Region V director over six states including Ohio, was in town this week for speaking engagements including the Columbus nonprofit Health Policy Institute of Ohio and Ohio Hospital Association and stopped atColumbus Business First, sister paper to the Dayton Business Journal.
The state’s employers, insurers and brokers have been getting antsy about whether Ohio will set up its own exchange where individuals and small businesses can compare coverage and premiums. The shopping sites go live in 2014, but if a state has not made substantial progress toward setting one up by next January, it will get subsumed into the federally run mega-exchange.
Democrats in the General Assembly have unsuccessfully tried to goose the processbut Ohio Lt. Gov. Mary Taylor, also the Department of Insurance director, said the state is still mulling its options.
http://www.bizjournals.com/dayton/news/2012/03/02/obama-official-puzzled-by-ohios.html
Hat Tip: BizJournals.com
Kenneth Munson, HHS Region V director over six states including Ohio, was in town this week for speaking engagements including the Columbus nonprofit Health Policy Institute of Ohio and Ohio Hospital Association and stopped atColumbus Business First, sister paper to the Dayton Business Journal.
The state’s employers, insurers and brokers have been getting antsy about whether Ohio will set up its own exchange where individuals and small businesses can compare coverage and premiums. The shopping sites go live in 2014, but if a state has not made substantial progress toward setting one up by next January, it will get subsumed into the federally run mega-exchange.
Democrats in the General Assembly have unsuccessfully tried to goose the processbut Ohio Lt. Gov. Mary Taylor, also the Department of Insurance director, said the state is still mulling its options.
http://www.bizjournals.com/dayton/news/2012/03/02/obama-official-puzzled-by-ohios.html
Hat Tip: BizJournals.com
New Mexico- Health Insurance Exchanges Nearing Launch Point
The New Mexico Human Services Department has issued a $24 million bid to build its computerized health insurance exchange.
The bid, or RFP, was issued Feb. 3. Responses from bidders are due March 8.
http://www.bizjournals.com/albuquerque/print-edition/2012/03/02/health-insurance-exchanges-nearing.html
Hat Tip: BizJournals.com
The bid, or RFP, was issued Feb. 3. Responses from bidders are due March 8.
http://www.bizjournals.com/albuquerque/print-edition/2012/03/02/health-insurance-exchanges-nearing.html
Hat Tip: BizJournals.com
Oregon- Insurance Exchange Bill Moves Toward Floor Vote
After weeks of being stuck in the Legislature’s Budget Committee, the bill allowing Oregon’s health insurance exchange to proceed toward implementation is moving toward a House and Senate vote —along with a little baggage in the form of a completely unrelated amendment supported by Republicans.
The legislation is expected to easily pass both chambers.
The Ways and Means Subcommittee on Capital Construction passed House Bill 4164 unanimously yesterday afternoon. The bill gives legislative approval of the Oregon health insurance exchange’s business plan, which provides financial projections and maps out how it will be ready to provide health insurance to individuals and small businesses (50 employees and under) starting in January 2014. It’s expected be a one-stop shopping place for as many as 700,000 uninsured individuals and small businesses to purchase affordable health insurance.
http://www.thelundreport.org/resource/insurance_exchange_bill_moves_toward_floor_vote_with_amendment_relating_to_oebb_opt_out
Hat Tip: The Lund Report
The legislation is expected to easily pass both chambers.
The Ways and Means Subcommittee on Capital Construction passed House Bill 4164 unanimously yesterday afternoon. The bill gives legislative approval of the Oregon health insurance exchange’s business plan, which provides financial projections and maps out how it will be ready to provide health insurance to individuals and small businesses (50 employees and under) starting in January 2014. It’s expected be a one-stop shopping place for as many as 700,000 uninsured individuals and small businesses to purchase affordable health insurance.
http://www.thelundreport.org/resource/insurance_exchange_bill_moves_toward_floor_vote_with_amendment_relating_to_oebb_opt_out
Hat Tip: The Lund Report
Pennsylvania- Gov. Tom Corbett Wants Health Insurance On His Terms
Recently, there have been negative comments on Gov. Tom Corbett’s decision to establish a Health Insurance Exchange and on legislators who intend to introduce enabling legislation.
It is suggested that the administration and General Assembly are endorsing the Patient Protection Affordable Care Act (PPACA, also known as Obamacare).
To suggest that conservative Republicans in Pennsylvania have suddenly decided to help President Obama shows a lack of understanding of this issue.
Pennsylvania is not legitimizing PPACA by establishing a Health Insurance Exchange.
Instead, Corbett and leaders of the General Assembly are looking at the range of choices and deciding that whatever we design will be better suited than whatever the U.S. Department of Health and Human Services imposes on us if Pennsylvania does not pass enabling legislation by Jan. 1, 2013.
http://www.pennlive.com/editorials/index.ssf/2012/03/gov_tom_corbett_wants_health_i.html
Hat Tip: PennLive.Com
It is suggested that the administration and General Assembly are endorsing the Patient Protection Affordable Care Act (PPACA, also known as Obamacare).
To suggest that conservative Republicans in Pennsylvania have suddenly decided to help President Obama shows a lack of understanding of this issue.
Pennsylvania is not legitimizing PPACA by establishing a Health Insurance Exchange.
Instead, Corbett and leaders of the General Assembly are looking at the range of choices and deciding that whatever we design will be better suited than whatever the U.S. Department of Health and Human Services imposes on us if Pennsylvania does not pass enabling legislation by Jan. 1, 2013.
http://www.pennlive.com/editorials/index.ssf/2012/03/gov_tom_corbett_wants_health_i.html
Hat Tip: PennLive.Com
Oklahoma- State Faces Health Exchange Deadline
Gov. Mary Fallin says she doesn't want a federal health-insurance exchange imposed on the state.
"The governor wants to avoid, at all costs, a federal Obama-care exchange being forced on the state of Oklahoma," Fallin spokesman Alex Weintz said in an email Friday.
"The governor wants to avoid, at all costs, a federal Obama-care exchange being forced on the state of Oklahoma," Fallin spokesman Alex Weintz said in an email Friday.
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Last year, the Oklahoma Republican Party split on whether and how to deal with those mandates.
Under pressure from tea party Republicans, three GOP bills to establish exchanges foundered, and Fallin had to tell federal officials to keep a $54 million grant to build an exchange after previously saying the state would accept the money.
After studying the controversy for months, a legislative task force has proposed repurposing the state's Insure Oklahoma program as an exchange.
The proposal would connect eligible Oklahomans to Medicaid and act as a place for businesses to buy insurance for workers, but it would not offer insurance to individuals. So Oklahomans who earn too much to get Medicaid but don't get insurance through their jobs would not have access to the federal subsidies.
http://www.tulsaworld.com/news/article.aspx?subjectid=336&articleid=20120304_11_A8_GovMar449188&r=3096
Hat Tip: Tulsa World
Last year, the Oklahoma Republican Party split on whether and how to deal with those mandates.
Under pressure from tea party Republicans, three GOP bills to establish exchanges foundered, and Fallin had to tell federal officials to keep a $54 million grant to build an exchange after previously saying the state would accept the money.
After studying the controversy for months, a legislative task force has proposed repurposing the state's Insure Oklahoma program as an exchange.
The proposal would connect eligible Oklahomans to Medicaid and act as a place for businesses to buy insurance for workers, but it would not offer insurance to individuals. So Oklahomans who earn too much to get Medicaid but don't get insurance through their jobs would not have access to the federal subsidies.
http://www.tulsaworld.com/news/article.aspx?subjectid=336&articleid=20120304_11_A8_GovMar449188&r=3096
Hat Tip: Tulsa World
Thursday, March 1, 2012
Washington- Senate passes health exchange bill
Despite Republican objections that it was moving too fast, and reported threats of political reprisals, the Senate approved changes to a system of shopping for medical insurance care that supporters liken to internet sites like Travelocity.
By a 27-22 vote, senators set new rules for the state’s fledgling health care exchange, which is being set up in conjunction with the federal Affordable Care Act.
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The Senate bill goes back to the House, where Rep. Eileen Cody, chairwoman of the Health Care and Wellness Committee, said she expected the new version to pass. Work on the exchange starts this month, but the final system isn’t scheduled to be up and running before fall of 2013.
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Some revisions likely will be needed next year, Keiser said: “Every piece of heavy lifting takes refinement. This is akin to trying to build Social Security on a state level.”
http://www.spokesman.com/blogs/spincontrol/2012/mar/01/senate-passes-health-exchange-bill/
Hat Tip: The Spokesman-Review
By a 27-22 vote, senators set new rules for the state’s fledgling health care exchange, which is being set up in conjunction with the federal Affordable Care Act.
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The Senate bill goes back to the House, where Rep. Eileen Cody, chairwoman of the Health Care and Wellness Committee, said she expected the new version to pass. Work on the exchange starts this month, but the final system isn’t scheduled to be up and running before fall of 2013.
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Some revisions likely will be needed next year, Keiser said: “Every piece of heavy lifting takes refinement. This is akin to trying to build Social Security on a state level.”
http://www.spokesman.com/blogs/spincontrol/2012/mar/01/senate-passes-health-exchange-bill/
Hat Tip: The Spokesman-Review
California- Study Looks at Language Barriers to Exchange Coverage
Communities of color are expected to make up a large portion of the California Health Benefit Exchange population. Many potential enrollees have limited English skills, which could get in the way of obtaining coverage.
That's according to a report due to be released today as a joint project of the UCLA Center for Health Policy Research, the California Pan-Ethnic Health Network and the UC Berkeley Center for Labor Research and Education.
"We estimate that about 2.65 million nonelderly adults will be eligible for the exchange. Of that 2.65 million, about 67% of them are people of color," UCLA researcher Daphna Gans said. "That's mostly Latino, followed by African American, then Asian."
That adds up to a minority population of about 1.8 million adults who will be exchange-eligible. But the bigger statistic, she said, deals with language.
"About 40% of that 2.6 million are LEP -- limited English proficiency," Gans said. "This is a sizable proportion of the individuals. That's more than one million people."
Language skills could be a significant hurdle for those potential exchange applicants, she said.
http://www.californiahealthline.org/capitol-desk/2012/2/language-may-limit-exchange-enrollment.aspx#ixzz1nsrf4OV7
Hat Tip: California Healthline
That's according to a report due to be released today as a joint project of the UCLA Center for Health Policy Research, the California Pan-Ethnic Health Network and the UC Berkeley Center for Labor Research and Education.
"We estimate that about 2.65 million nonelderly adults will be eligible for the exchange. Of that 2.65 million, about 67% of them are people of color," UCLA researcher Daphna Gans said. "That's mostly Latino, followed by African American, then Asian."
That adds up to a minority population of about 1.8 million adults who will be exchange-eligible. But the bigger statistic, she said, deals with language.
"About 40% of that 2.6 million are LEP -- limited English proficiency," Gans said. "This is a sizable proportion of the individuals. That's more than one million people."
Language skills could be a significant hurdle for those potential exchange applicants, she said.
http://www.californiahealthline.org/capitol-desk/2012/2/language-may-limit-exchange-enrollment.aspx#ixzz1nsrf4OV7
Hat Tip: California Healthline
National- GOP Governors Stall Health Insurance Exchange Plans
It's hard to find a governor who doesn’t agree that creating an organized marketplace to help consumers and small businesses shop for health insurance is a good idea. But when it comes to implementing the state-run exchanges called for in the controversial 2010 federal health law, many GOP governors are balking.
If they opt out of building their own exchanges, they would have to hand over control of the project to the federal government — something no governor wants to do. So instead of taking a hard line on the issue, a handful of governors have recently carved out a middle ground. They’re putting off a decision until June when the U.S. Supreme Court is expected to decide whether the health law is constitutional.
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Waiting with Nebraska are Alabama, Florida, Georgia, Indiana, Kansas, Missouri, Michigan, South Dakota, Texas, Virginia and Wisconsin, according to news reports compiled by the Center for Budget and Policy Priorities.
The big question is whether states that wait for the high court’s decision will be able to build an online insurance marketplace in time to meet federal deadlines. “It’s hard to tell,” says Joy Johnson Wilson, health policy director for the National Conference of State Legislatures. “There’s a lot going on behind the scenes.”
Wilson and others report that even in states where governors are holding off, a lot of work already has been done using federal grant money. Every state has received a $1 million planning grant, and 34 states and the District of Columbia have received a total of more than $600 million from the U.S. Department of Health and Human Services to build the state exchanges.
http://www.stateline.org/live/details/story?contentId=635661
Hat tip: Stateline.org
If they opt out of building their own exchanges, they would have to hand over control of the project to the federal government — something no governor wants to do. So instead of taking a hard line on the issue, a handful of governors have recently carved out a middle ground. They’re putting off a decision until June when the U.S. Supreme Court is expected to decide whether the health law is constitutional.
...
Waiting with Nebraska are Alabama, Florida, Georgia, Indiana, Kansas, Missouri, Michigan, South Dakota, Texas, Virginia and Wisconsin, according to news reports compiled by the Center for Budget and Policy Priorities.
The big question is whether states that wait for the high court’s decision will be able to build an online insurance marketplace in time to meet federal deadlines. “It’s hard to tell,” says Joy Johnson Wilson, health policy director for the National Conference of State Legislatures. “There’s a lot going on behind the scenes.”
Wilson and others report that even in states where governors are holding off, a lot of work already has been done using federal grant money. Every state has received a $1 million planning grant, and 34 states and the District of Columbia have received a total of more than $600 million from the U.S. Department of Health and Human Services to build the state exchanges.
http://www.stateline.org/live/details/story?contentId=635661
Hat tip: Stateline.org
National- The Future Role for Health Insurance Exchanges, Part 3
In an article in the February issue of Health Affairs journal, William Kramer, executive director for national health policy at the Pacific Business Group on Health in San Francisco, discusses the potential long-term role the public health insurance exchanges could play in helping larger companies manage their health care benefits.
Near-term Opportunities for 2014-2016
In the near term, companies could use the public exchanges to help pre-age-65 retirees who are not yet eligible for Medicare to obtain affordable health coverage. Companies that provide these retirees with only access to purchasing coverage at group health plan rates could easily move these individuals to the private marketplace once the exchanges are up and running.
Similarly, employers that provide some level of subsidized health insurance for pre-Medicare-eligible retirees could convert those subsidies into a defined contribution to a health reimbursement account that retirees could use to purchase coverage through an exchange. Part-time employees who do not usually receive access to employers’ group health plans could also find coverage through the exchanges immediately.
http://businessfinancemag.com/article/future-role-health-insurance-exchanges-part-3-0229
Hat Tip: Business Finance Magazine
Near-term Opportunities for 2014-2016
In the near term, companies could use the public exchanges to help pre-age-65 retirees who are not yet eligible for Medicare to obtain affordable health coverage. Companies that provide these retirees with only access to purchasing coverage at group health plan rates could easily move these individuals to the private marketplace once the exchanges are up and running.
Similarly, employers that provide some level of subsidized health insurance for pre-Medicare-eligible retirees could convert those subsidies into a defined contribution to a health reimbursement account that retirees could use to purchase coverage through an exchange. Part-time employees who do not usually receive access to employers’ group health plans could also find coverage through the exchanges immediately.
http://businessfinancemag.com/article/future-role-health-insurance-exchanges-part-3-0229
Hat Tip: Business Finance Magazine
Missouri- May Put Exchange Implementation on Ballot
Missouri’s Senate recently decided to send implementation of the health insurance exchange program mandated by President Obama’s health care law to the voters, taking the first step toward turning the exchange into a ballot issue which could be sent to the voters in November.
Democratic Gov. Jay Nixon supports implementation, but the Republican-led legislative branch has pushed back against the implementation of this key element of the president’s health care agenda, which would create a government-run marketplace for purchasing insurance.
Senate Bill 464 prohibits the establishment of an exchange in the state via executive order, requiring either approval from the General Assembly or at the ballot box. Missouri’s Senate passed the bill by a 25-8 vote—it must now pass the House before going to voters.
This would not be the first ballot issue in the state to reject a mandate from the federal government. In 2010 Missouri voted overwhelmingly in favor of Proposition C, which prohibited any mandatory purchase of insurance. If Missouri voters supported an exchange, officials would be required to implement a state-produced program by 2014 or turn over control to the federal government.
http://news.heartland.org/newspaper-article/2012/03/01/missouri-may-put-exchange-implementation-ballot
Hat Tip: Heartland.org
Democratic Gov. Jay Nixon supports implementation, but the Republican-led legislative branch has pushed back against the implementation of this key element of the president’s health care agenda, which would create a government-run marketplace for purchasing insurance.
Senate Bill 464 prohibits the establishment of an exchange in the state via executive order, requiring either approval from the General Assembly or at the ballot box. Missouri’s Senate passed the bill by a 25-8 vote—it must now pass the House before going to voters.
This would not be the first ballot issue in the state to reject a mandate from the federal government. In 2010 Missouri voted overwhelmingly in favor of Proposition C, which prohibited any mandatory purchase of insurance. If Missouri voters supported an exchange, officials would be required to implement a state-produced program by 2014 or turn over control to the federal government.
http://news.heartland.org/newspaper-article/2012/03/01/missouri-may-put-exchange-implementation-ballot
Hat Tip: Heartland.org
Texas- Struggles With Task of Setting Up Insurance Exchange
Comparison shopping is often confusing because most health insurance companies offer a smorgasbord of plans with annual premiums that can fluctuate depending on the costs of their medical services each year, frequency of use and other variables. One plan, for example, may be cheaper than another but cover fewer services and prescriptions. An exchange like the one operating in Massachusetts, on the other hand, would make it “easier to understand your options, understand the differences between them and make a choice,” Schwartz said.
Under the new health care legislation, each state would determine the level of services and benefits insurance carriers must provide to consumers. But a basic health coverage package, known as essential health benefits, is designed to assure consumers that at least minimum benefits are provided by every insurance company participating in their state’s exchange.
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Consultants for the exchange planners in Texas estimate that 1.7 million people would purchase insurance through the exchange. That creates a huge market for Aetna and other insurance companies that want to offer new health insurance plans through the exchange.
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Tom Banning, CEO of the Texas Academy of Physicians, is among those doctors and Texas hospitals that expect patients and caregivers to benefit from the creation of health exchanges.
“Ideally, the individuals with insurance will become more sophisticated users of health care and health insurance and focus on preventive measures so those more acute problems are addressed early and at less cost,” Banning said.
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Proponents say exchanges will create more competitive pricing.
“Better competition will help drive down insurance premiums, and that’s exactly what exchanges do,” said Blake Hutson, an Austin organizer of Consumers Union, a consumer advocacy group. “We need a new way to help families and workers, small businesses get health insurance and to help people who already have insurance but struggle with high rates. [A] health insurance exchange in Texas is the way to do that.”
Yet despite some of the advantages of a statewide exchange, Texas has not made any significant progress in establishing one. In the last legislative session, House Bill 636 — a bill to create the exchange — was held up in committee. Gov. Rick Perry made it clear he would veto bills creating the exchange.
The governor believes federal health insurance reform is “a misguided, unconstitutional and unsustainable government takeover of our health care,” said Lucy Nashed, his deputy press secretary.
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The new system is unsustainable, according to Harris, of the Texas Public Policy Foundation.
“All of these new taxes passed down to customers in addition to new insurance regulations are going to raise the cost of health care,” he said.
The cost of creating an insurance exchange is a concern to officials. The model specified by HB 636 would have cost $12 million annually in 2013 and 2014. Almost $4 million would have come from the state’s general revenue fund, and the rest would be funded by the federal government. Rep. John Zerwas, R-Simonton, author of the bill, says the model proposed by the bill has broad stakeholder approval and support.
http://www.dentonrc.com/local-news/local-news-headlines/20120301-texas-struggles-with-task-of-setting-up-insurance-exchange.ece
Hat Tip: Denton Record-Chronicle
Under the new health care legislation, each state would determine the level of services and benefits insurance carriers must provide to consumers. But a basic health coverage package, known as essential health benefits, is designed to assure consumers that at least minimum benefits are provided by every insurance company participating in their state’s exchange.
...
Consultants for the exchange planners in Texas estimate that 1.7 million people would purchase insurance through the exchange. That creates a huge market for Aetna and other insurance companies that want to offer new health insurance plans through the exchange.
...
Tom Banning, CEO of the Texas Academy of Physicians, is among those doctors and Texas hospitals that expect patients and caregivers to benefit from the creation of health exchanges.
“Ideally, the individuals with insurance will become more sophisticated users of health care and health insurance and focus on preventive measures so those more acute problems are addressed early and at less cost,” Banning said.
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Proponents say exchanges will create more competitive pricing.
“Better competition will help drive down insurance premiums, and that’s exactly what exchanges do,” said Blake Hutson, an Austin organizer of Consumers Union, a consumer advocacy group. “We need a new way to help families and workers, small businesses get health insurance and to help people who already have insurance but struggle with high rates. [A] health insurance exchange in Texas is the way to do that.”
Yet despite some of the advantages of a statewide exchange, Texas has not made any significant progress in establishing one. In the last legislative session, House Bill 636 — a bill to create the exchange — was held up in committee. Gov. Rick Perry made it clear he would veto bills creating the exchange.
The governor believes federal health insurance reform is “a misguided, unconstitutional and unsustainable government takeover of our health care,” said Lucy Nashed, his deputy press secretary.
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The new system is unsustainable, according to Harris, of the Texas Public Policy Foundation.
“All of these new taxes passed down to customers in addition to new insurance regulations are going to raise the cost of health care,” he said.
The cost of creating an insurance exchange is a concern to officials. The model specified by HB 636 would have cost $12 million annually in 2013 and 2014. Almost $4 million would have come from the state’s general revenue fund, and the rest would be funded by the federal government. Rep. John Zerwas, R-Simonton, author of the bill, says the model proposed by the bill has broad stakeholder approval and support.
http://www.dentonrc.com/local-news/local-news-headlines/20120301-texas-struggles-with-task-of-setting-up-insurance-exchange.ece
Hat Tip: Denton Record-Chronicle
Iowa- Senate to Hold a Public Forum on Health Care Exchange Today
The Iowa senate will today hold a public forum on a national directive some say Iowa is ignoring to create a health care exchange.
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Gov. Terry Branstad , who has signed on to litigation questioning the constitutionality of the reform, has indicated that the exchange could wait a year before its enacted by lawmakers. Sen. Jack Hatch, D-Des Moines, has said the wait would make it difficult for Iowa to move ahead because of the time involved in creating such programs.
http://www.desmoinesregister.com/article/20120301/NEWS09/120301005/1007/news05
Hat Tip: Des Moines Register
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Gov. Terry Branstad , who has signed on to litigation questioning the constitutionality of the reform, has indicated that the exchange could wait a year before its enacted by lawmakers. Sen. Jack Hatch, D-Des Moines, has said the wait would make it difficult for Iowa to move ahead because of the time involved in creating such programs.
http://www.desmoinesregister.com/article/20120301/NEWS09/120301005/1007/news05
Hat Tip: Des Moines Register
Ohio- Must Set Up Federally Mandated Health Exchanges
Deadlines loom for Ohio and other states to set up federally mandated health exchanges, intensifying debate over whether taking action or waiting for information carries the higher price tag.
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Setting up a federal-based exchange would cost Ohio an estimated $20 million, while creating a state-based exchange would cost $63 million, Lt. Gov. Mary Taylor said.
An estimated 685,000 Ohioans will pick their health plan and receive premium and cost-sharing subsidies through the exchanges, which must be in place by the beginning of 2014. States have some latitude in how they set up their own exchanges, and the federal government will step in and create exchanges in those states that don’t create their own. A hybrid exchange jointly run by the federal and state government is another possibility.
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Taylor, who doubles as director of the state Department of Insurance, said it has been difficult thus far to make a decision on which way Ohio should go in the absence of more information from the federal government of what a federal health exchange might look like.
“Setting up and operating an exchange, whether it’s a federal-based exchange or a state-based exchange, is expensive,” Taylor told a crowd of a few hundred gathered Wednesday at a forum on health-care exchanges organized by the nonpartisan Health Policy Institute of Ohio.
Taylor cited a study that estimated Ohio’s annual operating costs for an exchange — excluding information technology costs — would be $19 million to $34 million annually. Information technology costs are estimated to be $1.6 million for a federally run exchange, and up to $9 million for a state-based or state-run exchange.
...
Setting up a federal-based exchange would cost Ohio an estimated $20 million, while creating a state-based exchange would cost $63 million, Lt. Gov. Mary Taylor said.
An estimated 685,000 Ohioans will pick their health plan and receive premium and cost-sharing subsidies through the exchanges, which must be in place by the beginning of 2014. States have some latitude in how they set up their own exchanges, and the federal government will step in and create exchanges in those states that don’t create their own. A hybrid exchange jointly run by the federal and state government is another possibility.
...
Taylor, who doubles as director of the state Department of Insurance, said it has been difficult thus far to make a decision on which way Ohio should go in the absence of more information from the federal government of what a federal health exchange might look like.
“Setting up and operating an exchange, whether it’s a federal-based exchange or a state-based exchange, is expensive,” Taylor told a crowd of a few hundred gathered Wednesday at a forum on health-care exchanges organized by the nonpartisan Health Policy Institute of Ohio.
Taylor cited a study that estimated Ohio’s annual operating costs for an exchange — excluding information technology costs — would be $19 million to $34 million annually. Information technology costs are estimated to be $1.6 million for a federally run exchange, and up to $9 million for a state-based or state-run exchange.
Hat tip: Middletown Journal
National- Wait-and-See Approach to Health Exchanges May Haunt States
However, delaying a decision on whether to establish a state exchange until the summer could effectively be a decision to let the federal government set up the exchange.
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It’s hard to imagine how a state could take all the necessary legislative, policy, operational, and IT system development steps needed to meet this compressed timeline if it doesn’t start work until the summer.
A number of other states have forged ahead with development of their exchanges, and it’s fortunate that the ACA ensures that residents of all states will have access to affordable, decent-quality coverage options through an exchange, whether or not their state establishes one. But it would be unfortunate if some states lose the ability to set up their own exchange when their leaders decide to “wait and see.”
http://www.offthechartsblog.org/wait-and-see-approach-to-health-exchanges-may-haunt-states/
Hat Tip: Center on Budget and Policy Resources/ Off the Charts/ Dave Chandra
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