State Lawmakers Discuss Possible Partnerships for Health Plan Exchanges
With a number of states lagging in implementing the state health insurance exchanges under the federal health reform law, HHS officials have begun talks with state lawmakers about possible federal-state partnerships that would allow the federal government to assist states without completely taking over operations, the Washington Post reports (Aizenman, Washington Post, 9/10).
Under the federal health reform law, states by January 2014 must create insurance exchanges that provide coverage options for individuals and small businesses. States can choose to administer their own exchanges -- for which they must have some infrastructure in place by January 2013 -- or have the federal government run the exchanges for them (California Healthline, 8/14).
According to Timothy Jost -- a health policy expert at Washington and Lee University -- when the health reform law was passed, most experts believed the majority of states would run their own exchanges. However, Jost said, "[T]here is a growing concern that quite a number of states will not be ready."
Only about 12 states have made significant strides toward establishing exchanges, while about 33% are still in the early stages of planning. Some states already have missed a deadline to qualify for some federal funding because they have not yet acted and their legislatures are not scheduled to meet during a regular session before 2013.
Administration officials have not issued comments on the partnerships that could be arranged with states. However, several state officials have discussed arrangements that could be a model for future state-federal joint ventures. According to several Utah lawmakers, HHS offered to handle the exchange for individuals and let the state continue running its exchange that currently operates for small businesses.
Arkansas state Reps. Fred Allen (D) and state Rep. Jon Woods (R) said during a regional meeting in Denver that HHS officials suggested the federal government could temporarily run an exchange until Arkansas implements its own (Washington Post, 9/10).
N.Y. Republicans Balk at Special Session To Consider Exchange Legislation
Several GOP lawmakers in New York are resisting returning to Albany for a special session to consider exchange legislation, a move that could jeopardize federal funding for the exchange, the New York Times reports
Â Although the State Assembly approved a proposal by Gov. Andrew Cuomo (D) to create the exchange, the Republican-controlled Senate refused to discuss the legislation before it adjourned the regular session at the end of June.
The next deadline for states to apply to HHS for federal funding to help states establish exchanges is Sept. 30, and the state is "almost certainly going to miss it," according to the Times.
State Senate Democrats have urged Majority Leader Dean Skelos (R) to call lawmakers for a special session to enact the exchange bill before the next deadline, but a spokesperson for Skelos said the Senate has no plans to return to Albany to do so (Kaplan, New York Times, 9/11).
Virginia Council Approves Outline of Recommendations for Establishing Exchange
The Virginia Health Reform Initiative Advisory Council on Friday approved an outline for recommendations of the state's health insurance exchange, the Washington Times reports.
The council -- made up of state officials, lawmakers and stakeholders that were appointed by Gov. Bob McDonnell (R) -- approved the recommendations ahead of an Oct. 1 deadline. The recommendations now will be forwarded to McDonnell and the General Assembly.
The council recently voted to recommend that the exchange be a quasi-governmental agency that is financially self-supporting and has a board of between 11 and 15 members, who would be appointed by the governor and the General Assembly (Sherfinski, Washington Times, 9/10).
Oklahoma Lawmakers Back State's Request for MLR Waiver
Oklahoma's congressional delegation on Friday sent a letter urging HHS to accept the state's request for a waiver from medical-loss ratio rules, The Hill's "Healthwatch" reports (Baker, "Healthwatch," The Hill, 9/9).
Under the MLR rule, private insurers are required to spend at least 80% in the individual market or 85% in the group market of their premium dollars on direct medical costs. Insurers that do not comply with the ratio will have to issue rebates to consumers. So far, North Dakota is the only state to be denied an MLR waiver. HHS has approved waivers for five states, while nine other states are awaiting a decision (California Healthline, 7/26).
Meanwhile, Sen. Tom Coburn (R-Okla.) on Friday released a paper that outlines his objections to the MLR, which he said would limit consumer choice and lead to increases in premiums ("Healthwatch," The Hill, 9/9).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.