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
Showing posts with label Opinion. Show all posts
Showing posts with label Opinion. Show all posts
Monday, March 26, 2012
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
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
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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.
...
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
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
Monday, March 5, 2012
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
Thursday, March 1, 2012
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
Tuesday, February 28, 2012
Montana- Health Co-Op is a Good Idea for Uninsured Montanans
Critics of the 2-year-old Affordable Care Act don't like it — we're not sure they'd like anything that might actually work during a presidential election year — but it was heartening to see that Montana was on the short list of states to benefit from the first round of funding for health care co-ops.
Montana Health Cooperative got word last week that it would get $58 million in loans over a period of time to get started in the health insurance marketplace that will be created in the state and elsewhere in the next couple of years.
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The recent Assets & Opportunity Scorecard of the states by the Corporation for Enterprise Development said the state ranks 40th overall in uninsured rate, 48th in uninsured low-income parents and 45th in uninsured low-income children.
Some of those folks are the ones who stand to benefit by creation of the co-op.
John Morrison, former state insurance commissioner who helped form the Montana co-op and now is president of the National Alliance of Health Cooperatives, said the Montana organization "will be consumer-governed and will be responsive to consumer needs."
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But lo and behold two years after passage of the act — and about nine months after the newly formed Montana Health Cooperative announced that it planned to seek financial assistance under the act — the state co-op joins similar organizations in seven other states as the first federal loan recipients.
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Critics don't like the injection of government money into the health insurance system, but we'd wager most of them are either wealthy or have decent insurance mostly paid for by their employers.
The Montana Health Co-op won't be able to serve a large portion of the thousands of uninsured Montanans, but it might help create a marketplace that will be more accessible to them.
http://www.greatfallstribune.com/article/20120228/OPINION/202280306
Hat Tip: Great Falls Tribune
Montana Health Cooperative got word last week that it would get $58 million in loans over a period of time to get started in the health insurance marketplace that will be created in the state and elsewhere in the next couple of years.
...
The recent Assets & Opportunity Scorecard of the states by the Corporation for Enterprise Development said the state ranks 40th overall in uninsured rate, 48th in uninsured low-income parents and 45th in uninsured low-income children.
Some of those folks are the ones who stand to benefit by creation of the co-op.
John Morrison, former state insurance commissioner who helped form the Montana co-op and now is president of the National Alliance of Health Cooperatives, said the Montana organization "will be consumer-governed and will be responsive to consumer needs."
...
But lo and behold two years after passage of the act — and about nine months after the newly formed Montana Health Cooperative announced that it planned to seek financial assistance under the act — the state co-op joins similar organizations in seven other states as the first federal loan recipients.
...
Critics don't like the injection of government money into the health insurance system, but we'd wager most of them are either wealthy or have decent insurance mostly paid for by their employers.
The Montana Health Co-op won't be able to serve a large portion of the thousands of uninsured Montanans, but it might help create a marketplace that will be more accessible to them.
http://www.greatfallstribune.com/article/20120228/OPINION/202280306
Hat Tip: Great Falls Tribune
Monday, February 27, 2012
New Hampshire- NH Should Create its Own Exchanges
An exchange focuses competition on price. And the exchanges are intended to bring sunlight and transparence to the world of health insurance.
Exchanges will be designed as a place where individuals, small employers and eventually larger employers can shop and compare health insurance options.
The law requires that all states have an exchange in place by 2014. States can create their own or choose to let the federal government set the design.
Our New Hampshire Legislature and Executive Council have been stalwart in putting obstacles to a state-designed and implemented exchange.
This year, the Legislature has chosen to table a Senate bill that would set a process for a New Hampshire-designed exchange and made a committee recommendation to pass a leadership-sponsored bill (HB 1297) that New Hampshire “shall not plan, create, participate in or enable a state exchange for health insurance.”
Insurers, providers and small businesses support the concept that New Hampshire design an exchange that is unique to us, one best for New Hampshire. So why isn’t it happening?
Although Republicans can take credit for initiating the idea of an exchange – the conservative Heritage Foundation first touted the idea – many Republicans, and most certainly those extreme members of the Legislature, find all things “Obamacare “objectionable, apparently whether good policy or not.
Let’s look for the silver lining. If our Legislature persists on its current path, the federal government will design an exchange for us. Perhaps given the lack of leadership in our Legislature, that might turn out to be a good thing.
http://www.nashuatelegraph.com/opinionperspectives/951510-263/nh-should-create-its-own-exchanges.html
Hat Tip: Nashua Telegraph
Exchanges will be designed as a place where individuals, small employers and eventually larger employers can shop and compare health insurance options.
The law requires that all states have an exchange in place by 2014. States can create their own or choose to let the federal government set the design.
Our New Hampshire Legislature and Executive Council have been stalwart in putting obstacles to a state-designed and implemented exchange.
This year, the Legislature has chosen to table a Senate bill that would set a process for a New Hampshire-designed exchange and made a committee recommendation to pass a leadership-sponsored bill (HB 1297) that New Hampshire “shall not plan, create, participate in or enable a state exchange for health insurance.”
Insurers, providers and small businesses support the concept that New Hampshire design an exchange that is unique to us, one best for New Hampshire. So why isn’t it happening?
Although Republicans can take credit for initiating the idea of an exchange – the conservative Heritage Foundation first touted the idea – many Republicans, and most certainly those extreme members of the Legislature, find all things “Obamacare “objectionable, apparently whether good policy or not.
Let’s look for the silver lining. If our Legislature persists on its current path, the federal government will design an exchange for us. Perhaps given the lack of leadership in our Legislature, that might turn out to be a good thing.
http://www.nashuatelegraph.com/opinionperspectives/951510-263/nh-should-create-its-own-exchanges.html
Hat Tip: Nashua Telegraph
Sunday, February 19, 2012
Opinion- Iowa: Utah or Massachusetts? No, it’s Iowa
We met recently with two groups pushing for establishment of health insurance exchanges in Iowa. One of the 2010 federal Affordable Care Act’s central requirements is for each state to establish an exchange, where individuals, businesses and organizations can select from a variety of insurance options. It’s supposed to encourage competition among insurers and give consumers more affordable choices.
Both the Iowa Health Alliance and the Iowa Health Advocates want the Iowa Legislature to authorize work on an exchange sooner than later. They argue that waiting until July for the U.S. Supreme Court ruling on the ACA’s mandate that every individual must have health insurance coverage is too late.
We agree. Legislators have to authorize a plan by Jan. 1; otherwise, the federal government will do it for us. Yes, depending on the November election outcome, Congress could throw out the exchange requirement, as well as any other or all parts of the ACA regardless of how the high court rules on the mandate.
But waiting because of the uncertainties doesn’t seem wise.
...
Each plan provides some lessons. But Iowa should not get hung up on any other state’s model. Our exchange’s governing body should be transparent, independent and represent both consumer and business interests. We also see merit in having the insurance industry serve in an advisory capacity only to avoid conflicts of interest.
Bottom line: Devise a plan to fit Iowans’ needs.
http://thegazette.com/2012/02/19/utah-or-massachusetts-no-its-iowa/
Hat tip: The Gazette
Both the Iowa Health Alliance and the Iowa Health Advocates want the Iowa Legislature to authorize work on an exchange sooner than later. They argue that waiting until July for the U.S. Supreme Court ruling on the ACA’s mandate that every individual must have health insurance coverage is too late.
We agree. Legislators have to authorize a plan by Jan. 1; otherwise, the federal government will do it for us. Yes, depending on the November election outcome, Congress could throw out the exchange requirement, as well as any other or all parts of the ACA regardless of how the high court rules on the mandate.
But waiting because of the uncertainties doesn’t seem wise.
...
Each plan provides some lessons. But Iowa should not get hung up on any other state’s model. Our exchange’s governing body should be transparent, independent and represent both consumer and business interests. We also see merit in having the insurance industry serve in an advisory capacity only to avoid conflicts of interest.
Bottom line: Devise a plan to fit Iowans’ needs.
http://thegazette.com/2012/02/19/utah-or-massachusetts-no-its-iowa/
Hat tip: The Gazette
Opinion- Idaho: Will Playing Politics Really Pay Off?
Two months ago, state legislators by and large declared health insurance exchanges would become the big issue of this session.
Now, as a bill on the matter finally emerges, the question becomes how the Legislature will treat this issue in an already-shrill election year: politically, or in the practical way it deserves?
For several months, Rep. Fred Wood, R-Burley, and Sen. Dean Cameron, R-Rupert, have worked on legislation that would establish a state-operated health insurance exchange, one of the provisions of the federal health care reforms dubbed “Obamacare.”
Meanwhile, Idaho is one of many states that has sued over Obamacare and now awaits a decision this summer from the U.S. Supreme Court. Idaho Falls state Rep. Janice McGeachin is throwing down as many roadblocks to the process as she can, this week proposing the Legislature create a committee to ponder the issue for a while. House opposition has led Gov. C.L. “Butch” Otter to drop plans to use federal funding to help start the exchange, putting more pressure on an already-tight state budget. Otter worries the state doesn’t have enough time to set its exchange up by the federal due date anyway.
The clock is ticking. What’s a legislator to do?
...
Legislators trying to ignore the health reforms should ask themselves this: If Idaho’s lawsuit doesn’t go their way, will the state be prepared to make the best of the federal law? Or in attempting to reject a perceived federal overreach, are they setting the state up to possibly lose both its court case and any control over its insurance exchange?
Right and wrong are always in the eye of the beholder. For some in Boise, it’s apparently hard to see much of anything at all.
http://magicvalley.com/news/opinion/editorial/our-view-will-playing-politics-really-pay-off/article_29e72c7c-9fed-59ad-948a-2c86a5849c6f.html
Hat tip: Magic Valley Times-News
Now, as a bill on the matter finally emerges, the question becomes how the Legislature will treat this issue in an already-shrill election year: politically, or in the practical way it deserves?
For several months, Rep. Fred Wood, R-Burley, and Sen. Dean Cameron, R-Rupert, have worked on legislation that would establish a state-operated health insurance exchange, one of the provisions of the federal health care reforms dubbed “Obamacare.”
Meanwhile, Idaho is one of many states that has sued over Obamacare and now awaits a decision this summer from the U.S. Supreme Court. Idaho Falls state Rep. Janice McGeachin is throwing down as many roadblocks to the process as she can, this week proposing the Legislature create a committee to ponder the issue for a while. House opposition has led Gov. C.L. “Butch” Otter to drop plans to use federal funding to help start the exchange, putting more pressure on an already-tight state budget. Otter worries the state doesn’t have enough time to set its exchange up by the federal due date anyway.
The clock is ticking. What’s a legislator to do?
...
Legislators trying to ignore the health reforms should ask themselves this: If Idaho’s lawsuit doesn’t go their way, will the state be prepared to make the best of the federal law? Or in attempting to reject a perceived federal overreach, are they setting the state up to possibly lose both its court case and any control over its insurance exchange?
Right and wrong are always in the eye of the beholder. For some in Boise, it’s apparently hard to see much of anything at all.
http://magicvalley.com/news/opinion/editorial/our-view-will-playing-politics-really-pay-off/article_29e72c7c-9fed-59ad-948a-2c86a5849c6f.html
Hat tip: Magic Valley Times-News
Opinion- Texas: Lagging on Health Exchanges
In Rick Perry's Texas, nearly 1 in 3 working-age residents has no health insurance, so there's a price to pay for his pride and politics.
Count the millions of federal dollars being left on the table, because the governor refuses to begin work on a healthcare exchange. As important, count the opportunity costs -- the missed chances to create a better health insurance market for millions of Texans who need individual and small-company plans.
A frequent criticism of the 2010 healthcare law is that it forces a cookie-cutter solution on all. Not so with health exchanges, the online shopping sites envisioned as a Travelocity for health insurance.
...
Even conservative stalwarts like Mississippi and Utah have already taken steps to avoid the federal option.
While Perry complains about being fed-up with Washington, others are seizing the moment and the money. Thirteen states have established exchanges, tackling issues such as the makeup of governing boards, mandated benefits and which insurers to allow into the mix.
Twenty-eight states and the District of Columbia have received first-level grants to establish their programs. Federal payouts include $1.6 million to Tennessee, $21 million to Missouri and $39 million to California.
...
But even if the law were overturned, shouldn't Texas be working on its own exchange? And on the feds' nickel?
This is different from many health law requirements. Most conservatives oppose the large expansion of Medicaid, the federal mandate to buy coverage and the premium rebates that insurers must pay if they spend too much on overhead.
But exchanges are a bet on free markets, rather than regulators. As tools, they can let consumers and insurers determine much of what happens in the marketplace.
Texas has been an innovator in electric deregulation, and its power-to-choose website has revolutionized the way people buy electricity here. They can easily compare plans, prices, complaint records and the share of power that comes from renewable energy. Retailers tout their service and inducements like frequent-flier miles.
If not for the politics, Texas could be a leader in developing a similar system for health insurance. In the 1990s, it created an insurance exchange for small businesses. That failed, because insurers outside the exchange offered lower-price coverage to healthy customers; in effect, that confirmed the problems of so-called adverse selection.
http://www.star-telegram.com/2012/02/18/3744532/perrys-texas-is-lagging-on-health.html
Hat tip: Fort Worth Star-Telegram
Count the millions of federal dollars being left on the table, because the governor refuses to begin work on a healthcare exchange. As important, count the opportunity costs -- the missed chances to create a better health insurance market for millions of Texans who need individual and small-company plans.
A frequent criticism of the 2010 healthcare law is that it forces a cookie-cutter solution on all. Not so with health exchanges, the online shopping sites envisioned as a Travelocity for health insurance.
...
Even conservative stalwarts like Mississippi and Utah have already taken steps to avoid the federal option.
While Perry complains about being fed-up with Washington, others are seizing the moment and the money. Thirteen states have established exchanges, tackling issues such as the makeup of governing boards, mandated benefits and which insurers to allow into the mix.
Twenty-eight states and the District of Columbia have received first-level grants to establish their programs. Federal payouts include $1.6 million to Tennessee, $21 million to Missouri and $39 million to California.
...
But even if the law were overturned, shouldn't Texas be working on its own exchange? And on the feds' nickel?
This is different from many health law requirements. Most conservatives oppose the large expansion of Medicaid, the federal mandate to buy coverage and the premium rebates that insurers must pay if they spend too much on overhead.
But exchanges are a bet on free markets, rather than regulators. As tools, they can let consumers and insurers determine much of what happens in the marketplace.
Texas has been an innovator in electric deregulation, and its power-to-choose website has revolutionized the way people buy electricity here. They can easily compare plans, prices, complaint records and the share of power that comes from renewable energy. Retailers tout their service and inducements like frequent-flier miles.
If not for the politics, Texas could be a leader in developing a similar system for health insurance. In the 1990s, it created an insurance exchange for small businesses. That failed, because insurers outside the exchange offered lower-price coverage to healthy customers; in effect, that confirmed the problems of so-called adverse selection.
http://www.star-telegram.com/2012/02/18/3744532/perrys-texas-is-lagging-on-health.html
Hat tip: Fort Worth Star-Telegram
Thursday, February 16, 2012
Opinion- Nebraska: Insurance Exchanges Need to Work for Rural Nebraskans
The Nebraska Legislature will soon be debating the merit of the development of a health insurance exchange in Nebraska. Rural places and their residents have unique circumstances that must be considered and addressed in the development of Exchanges. It is important to note that rural patients face the most daunting of health care challenges: they are older, poorer and sicker. Rural America is less healthy due to too much smoking, drinking and eating, and too little exercise, education, jobs and income.
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Health insurance exchanges must assure rural relevant risk sharing. We understand and support the value in the pooling of risk amongst insurers that occur amongst qualified plans for sales both inside and outside of the exchange. By pooling risk across a larger portion of the population relative to the individual market, exchanges will spread risk and create a much more stable market place. Exchanges can both reduce premium costs for residents and attract a greater volume of health plans to the market. In the past, many health plans have competed on who was best at avoiding sick people. The elimination of medical underwriting is hugely important to this principle, but it could be lost if the individual mandate and accompanying tax credits is eliminated as a consequence to adverse action by the courts.
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We realize that some have argued that national health plans are antagonistic to individual state exchanges and much prefer to compete within the context of a single set of rules determined by the Federal government as default for those states who do not establish an exchange by 2014. However, we believe that there are many high-value in-state insurance products that have developed and that these products will better continue to flourish with state-based exchanges. We believe the quality of products will increase more if exchanges facilitate a consistent set of metrics that are the focus of any incentives by health plans within the exchange.
The Nebraska Rural Health Association sees the exchanges as a critical tool for expanding access to health insurance coverage, while fostering value-based competition among private plans to promote quality and efficiency. Exchanges are particularly important in rural communities as they are in general more dependent on the individual and small group markets. To the detriment of rural communities, many have seen these markets as being less functional than the market for larger employers.
http://www.journaldemocrat.com/ag_news/x440451529/OPINION-Insurance-Exchanges-Need-to-Work-for-Rural-Nebraska
Hat tip: Syracuse Journal-Democrat
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Health insurance exchanges must assure rural relevant risk sharing. We understand and support the value in the pooling of risk amongst insurers that occur amongst qualified plans for sales both inside and outside of the exchange. By pooling risk across a larger portion of the population relative to the individual market, exchanges will spread risk and create a much more stable market place. Exchanges can both reduce premium costs for residents and attract a greater volume of health plans to the market. In the past, many health plans have competed on who was best at avoiding sick people. The elimination of medical underwriting is hugely important to this principle, but it could be lost if the individual mandate and accompanying tax credits is eliminated as a consequence to adverse action by the courts.
...
We realize that some have argued that national health plans are antagonistic to individual state exchanges and much prefer to compete within the context of a single set of rules determined by the Federal government as default for those states who do not establish an exchange by 2014. However, we believe that there are many high-value in-state insurance products that have developed and that these products will better continue to flourish with state-based exchanges. We believe the quality of products will increase more if exchanges facilitate a consistent set of metrics that are the focus of any incentives by health plans within the exchange.
The Nebraska Rural Health Association sees the exchanges as a critical tool for expanding access to health insurance coverage, while fostering value-based competition among private plans to promote quality and efficiency. Exchanges are particularly important in rural communities as they are in general more dependent on the individual and small group markets. To the detriment of rural communities, many have seen these markets as being less functional than the market for larger employers.
http://www.journaldemocrat.com/ag_news/x440451529/OPINION-Insurance-Exchanges-Need-to-Work-for-Rural-Nebraska
Hat tip: Syracuse Journal-Democrat
Opinion- Maryland: Health Exchanges Will Benefit Maryland Families
It's no wonder Maryland families are so hard pressed to find good, affordable health insurance — premiums have outpaced earnings, and the field of insurance options is confusing. Even if a family is fortunate enough to have coverage, it's hard to know if what you're paying for is going to be there for you when you need it. That's why our Health Care for All Coalition is so excited about Gov.Martin O'Malley's health care bill (SB 238). By setting up a competitive insurance marketplace for private health insurance, also known as an exchange, this bill will give Marylanders more choice, more control and more peace of mind about their health care.
In Maryland, the average premium for family coverage in an HMO went up 42 percent in just six years, from $9,573 in 2004 to $13,613 in 2010. At the same time, the median family income declined 2 percent (adjusted for inflation). As a result of this disparity, 14.5 percent of non-elderly Marylanders, or 720,000 people, are uninsured. Given the recent economic turmoil, this would have been even worse but for the expansion of health care coverage in recent years to more than 300,000 Marylanders, funded in large part by a lifesaving increase in the state tobacco tax.
Fortunately, the federal health care law known as the Affordable Care Act has created a tremendous opportunity for states to make health care more affordable by creating exchanges that are better marketplaces for private health insurance. The O'Malley administration's bill takes advantage of this opportunity and leads the country in implementing a stronger, redesigned health care system.
http://www.baltimoresun.com/news/opinion/oped/bs-ed-health-exchange-20120215,0,731307.story
Hat tip: Baltimore Sun
In Maryland, the average premium for family coverage in an HMO went up 42 percent in just six years, from $9,573 in 2004 to $13,613 in 2010. At the same time, the median family income declined 2 percent (adjusted for inflation). As a result of this disparity, 14.5 percent of non-elderly Marylanders, or 720,000 people, are uninsured. Given the recent economic turmoil, this would have been even worse but for the expansion of health care coverage in recent years to more than 300,000 Marylanders, funded in large part by a lifesaving increase in the state tobacco tax.
Fortunately, the federal health care law known as the Affordable Care Act has created a tremendous opportunity for states to make health care more affordable by creating exchanges that are better marketplaces for private health insurance. The O'Malley administration's bill takes advantage of this opportunity and leads the country in implementing a stronger, redesigned health care system.
http://www.baltimoresun.com/news/opinion/oped/bs-ed-health-exchange-20120215,0,731307.story
Hat tip: Baltimore Sun
Tuesday, February 14, 2012
Opinion- Florida: Missed Opportunities to Improve Health Care
Despite the hostility of Gov. Rick Scott and the Republican-controlled Legislature to the federal health care reform law, Florida organizations have received $119.6 million in funds from it over the last two years. A new study shows that money largely went to nongovernmental groups to fund essential health services while the state lost out on tens of millions because of the governor's opposition. So while private groups prepare, Tallahassee fiddles.
One of those missed opportunities is the money that flowed to states that started developing their own state-based health insurance exchanges. Scott's decision not to prepare for 2014, when the state exchanges are fully operational, likely means the federal government will have to establish Affordable Insurance Exchanges for Floridians instead.
...
The point of states developing their own exchange is to allow for flexibility and innovation, giving each state the opportunity to meet the needs of its own residents. But Scott is intent on having Florida watch from the sidelines, even as other states with Republican governors such as Alabama prepare. Alabama received more than $8.5 million in federal exchange establishment grants after an exchange study commission, created by the Republican governor who opposes the federal law, issued recommendations for implementation.
http://www.tampabay.com/opinion/editorials/floridas-missed-opportunities-to-improve-health-care/1215293
Hat tip: Tampa Bay Times
One of those missed opportunities is the money that flowed to states that started developing their own state-based health insurance exchanges. Scott's decision not to prepare for 2014, when the state exchanges are fully operational, likely means the federal government will have to establish Affordable Insurance Exchanges for Floridians instead.
...
The point of states developing their own exchange is to allow for flexibility and innovation, giving each state the opportunity to meet the needs of its own residents. But Scott is intent on having Florida watch from the sidelines, even as other states with Republican governors such as Alabama prepare. Alabama received more than $8.5 million in federal exchange establishment grants after an exchange study commission, created by the Republican governor who opposes the federal law, issued recommendations for implementation.
http://www.tampabay.com/opinion/editorials/floridas-missed-opportunities-to-improve-health-care/1215293
Hat tip: Tampa Bay Times
Monday, February 13, 2012
Opinion- National: Small Business Owners Not Expected to Opt Out of Health Care Reform
Only a few employers will take advantage of rules allowing some small businesses to avoid pending health reform measures, rendering the rules relatively obsolete and minimizing their impact on health insurance costs, according to new analysis and simulations conducted by health policy researchers.
Most small employers aren’t expected to take advantage of rules that would allow them to avoid upcoming health care reform measures. But that could change if the rules are rewritten to extend the opt-out offer to more companies, according to the study by RAND Corporation, a nonprofit policy research group. By letting more employers keep their old plans, experts say the government would drive up premiums offered to small employers through health insurance exchanges and consequently slash enrollment in those programs.
“We found that keeping the rules as they are written, particularly the limitations on maintaining a grandfathered plan, will be essential to keeping premiums affordable in small business insurance exchanges,” Christine Eibner, the study’s lead author and RAND senior economist, said in a statement.
Most small employers aren’t expected to take advantage of rules that would allow them to avoid upcoming health care reform measures. But that could change if the rules are rewritten to extend the opt-out offer to more companies, according to the study by RAND Corporation, a nonprofit policy research group. By letting more employers keep their old plans, experts say the government would drive up premiums offered to small employers through health insurance exchanges and consequently slash enrollment in those programs.
“We found that keeping the rules as they are written, particularly the limitations on maintaining a grandfathered plan, will be essential to keeping premiums affordable in small business insurance exchanges,” Christine Eibner, the study’s lead author and RAND senior economist, said in a statement.
Hat tip: Washington Post/ On Small Business/ J.D. Harrison
Opinion- Iowa: Politics Has No Place In Health-Care Exchanges
We are in the midst of complex health-care issues in our country and state. The Health Benefits Exchange, which is on the horizon, is an opportunity to listen with our head and our heart. It is an opportunity to work together and hear the voices of all in this state who will depend on it to shape a healthy future.
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Questions about health care’s best structure are legitimate, but ensuring that the Health Benefits Exchange is shaped and governed by those who will rely on it is necessary for better health care in this great state.
Let’s choose to move beyond the politics of polarization; that would be a giant step forward toward a more healthy state. And then may we use all the love God gives us for the good of all.
http://www.duluthnewstribune.com/event/article/id/222570/group/Opinion/
Hat tip: Duluth News Tribune
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Questions about health care’s best structure are legitimate, but ensuring that the Health Benefits Exchange is shaped and governed by those who will rely on it is necessary for better health care in this great state.
Let’s choose to move beyond the politics of polarization; that would be a giant step forward toward a more healthy state. And then may we use all the love God gives us for the good of all.
http://www.duluthnewstribune.com/event/article/id/222570/group/Opinion/
Hat tip: Duluth News Tribune
Opinion- Iowa: Advocates say Insurance Agents Should Not Control Iowa’s Exchange
With millions of dollars on the table, Iowa needs transparency and fairness in its new health insurance exchange to protect consumers, according to an advocacy group of patient organizations.
Representatives of Iowa Health Advocates say those consumers need to be central to the governing body of the new exchange, rather than allowing insurance agents or brokers to run the show.
Agents and brokers with a financial interest in the exchange have a direct conflict of interest, said Erin Seidler, state lead for Know Your Care Iowa, one of more than 30 groups represented in Iowa Health Advocates.
Their expertise could be used in an advisory board to provide guidance to the governing body of the exchange, Seidler said during a meeting Thursday with The Gazette Editorial Board.
http://thegazette.com/2012/02/12/advocates-say-insurance-agents-should-not-control-iowas-new-health-insurance-exchange/
Hat tip: The Gazette
Representatives of Iowa Health Advocates say those consumers need to be central to the governing body of the new exchange, rather than allowing insurance agents or brokers to run the show.
Agents and brokers with a financial interest in the exchange have a direct conflict of interest, said Erin Seidler, state lead for Know Your Care Iowa, one of more than 30 groups represented in Iowa Health Advocates.
Their expertise could be used in an advisory board to provide guidance to the governing body of the exchange, Seidler said during a meeting Thursday with The Gazette Editorial Board.
http://thegazette.com/2012/02/12/advocates-say-insurance-agents-should-not-control-iowas-new-health-insurance-exchange/
Hat tip: The Gazette
Thursday, February 9, 2012
Opinion- Virginia: Foot-Dragging on Obamacare
Faced with a federal mandate of next January to show that they are making progress, Richmond legislators have dilly-dallied past the problem, many apparently fearful that too much action on setting up state-run exchanges for people to shop for health insurance will bring on conservative wrath.
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Republican Gov. Robert F. McDonnell has been publicly silent recently on the legislative debate, but it is clear where he stands. He wants the state to avoid setting up exchanges until the U.S. Supreme Court rules on Obamacare. As a potential GOP vice presidential candidate, he hardly wants to get too far ahead on a federal program despised by the right wing.
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With the clock ticking on this year’s session, it seems likely that nothing will get done. This once again raises the question of state vs. federal rights — one in which Virginia has a dark past. There is a tendency in the Old Dominion to ignore federal laws or court rulings it doesn’t like. The shining example is Massive Resistance, in which the state’s official policy was not to integrate schools and close many down rather than bow to the legal power of the U.S. Supreme Court.
There are echoes of that movement in what we’re seeing today.
http://www.washingtonpost.com/blogs/all-opinions-are-local/post/foot-dragging-on-obamacare/2011/03/10/gIQA3I5f1Q_blog.html
Hat tip: Washington Post/ All Opinions Are Local/ Peter Galuszka writes at: Bacon's Rebellion
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Republican Gov. Robert F. McDonnell has been publicly silent recently on the legislative debate, but it is clear where he stands. He wants the state to avoid setting up exchanges until the U.S. Supreme Court rules on Obamacare. As a potential GOP vice presidential candidate, he hardly wants to get too far ahead on a federal program despised by the right wing.
...
With the clock ticking on this year’s session, it seems likely that nothing will get done. This once again raises the question of state vs. federal rights — one in which Virginia has a dark past. There is a tendency in the Old Dominion to ignore federal laws or court rulings it doesn’t like. The shining example is Massive Resistance, in which the state’s official policy was not to integrate schools and close many down rather than bow to the legal power of the U.S. Supreme Court.
There are echoes of that movement in what we’re seeing today.
http://www.washingtonpost.com/blogs/all-opinions-are-local/post/foot-dragging-on-obamacare/2011/03/10/gIQA3I5f1Q_blog.html
Hat tip: Washington Post/ All Opinions Are Local/ Peter Galuszka writes at: Bacon's Rebellion
Opinion- Nebraska: Moving Forward is Best for Nebraskans
One thing is certain: Nebraskans are best served by moving forward with efforts to establish a state-based health insurance exchange.
Nebraskans support these efforts to ensure the federal government will not be allowed control over our exchange. It's vital for Nebraskans to have a voice in the future of their health care, and as a member of the Nebraska Health Care Alliance I look forward to working with the Legislature to make sure this privilege stays where it belongs.
Maintaining a state-based exchange empowers Nebraskans to determine which plans suit them best and preserves our state's right to control its health insurance marketplace. Allowing individuals and small businesses to shop, compare and enroll in plans of their choosing will foster competition and create more reasonable costs for everyone. In addition, it can be set in place to help consumers make informed comparisons, distinguish the true value of each plan and educate everyone on healthy lifestyle choices.
http://journalstar.com/news/opinion/editorial/columnists/local-view-moving-forward-is-best-for-nebraskans/article_750512c6-f1b8-5915-928e-3844d6d4ed25.html
Hat tip: Journal Star
Nebraskans support these efforts to ensure the federal government will not be allowed control over our exchange. It's vital for Nebraskans to have a voice in the future of their health care, and as a member of the Nebraska Health Care Alliance I look forward to working with the Legislature to make sure this privilege stays where it belongs.
Maintaining a state-based exchange empowers Nebraskans to determine which plans suit them best and preserves our state's right to control its health insurance marketplace. Allowing individuals and small businesses to shop, compare and enroll in plans of their choosing will foster competition and create more reasonable costs for everyone. In addition, it can be set in place to help consumers make informed comparisons, distinguish the true value of each plan and educate everyone on healthy lifestyle choices.
http://journalstar.com/news/opinion/editorial/columnists/local-view-moving-forward-is-best-for-nebraskans/article_750512c6-f1b8-5915-928e-3844d6d4ed25.html
Hat tip: Journal Star
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