AHIP Voices Concerns With Oversight Rules for Insurance Exchanges
Although America's Health Insurance Plans previously expressed support for state-based health insurance exchanges, the group appears to have substantial concerns about the level of regulatory authority over the exchanges, CongressDaily reports (McCarthy, CongressDaily, 10/6).
Details of Exchanges
Under the federal health reform law, states by January 2014 must create insurance exchanges that provide coverage options for individuals and small businesses.
The exchanges are intended to foster a competitive market and hold insurers to strict new standards while attracting consumers.
States can choose to administer their own exchanges, for which they must have some infrastructure in place by January 2013, or ask the government to run the exchanges for them (California Healthline, 10/1).
In written comments submitted Oct. 4 to HHS, AHIP Senior Vice President Jeffrey Gabardi said, "Instead of serving as a regulator and attempting to duplicate existing regulatory bodies, the exchange should leave regulation and enforcement to existing agencies."
Gabardi highlighted premium rate review as one of the authorities that should be addressed separately by state insurance regulators.
The comments recommend that the exchanges' leadership be independent from existing regulatory bodies.
Gabardi also wrote that the group opposes state- or government-created bidding processes for health plans to participate in the exchanges, adding that the exchanges should "ensure that a robust set of choices" are available to consumers by avoiding "approaches that provide too much discretion to an exchange to selectively choose participants."
HHS Secretary Kathleen Sebelius will certify whether plans in the exchanges meet a number of criteria, including offering access to a sufficient number of providers.
Response to Letter
A senior Senate Democratic aide said that the exchanges were created in an attempt to set higher standards for participation than the current insurance market, adding that most of the exchanges likely would be established within existing state insurance departments.
The aide said, "This is for quality insurance plans," adding that "it is definitely not our intent to put up a website and allow companies to list their plans" (CongressDaily, 10/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.