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Gov. Haley’s Healthcare Advisory Group Seeks Extension

From The Post & Courier:



Thursday, October 20, 2011

A state committee tasked with determining how health insurance will be sold once federal health care reform takes full effect in 2014 is asking for a monthlong extension to make its recommendations to the governor.

Gary Thibault, director of the S.C. Health Planning Committee, asked for the group’s deadline to be moved to Nov. 30 so it could have “sufficient time to review the research, analysis and information before it and to develop its recommendations,” according to a letter he sent to Gov. Nikki Haley on Wednesday. The original deadline was Oct. 28. Continue reading

Insurance Exchanges Could Ease Burden On Small Biz

From The Atlanta Journal-Constitution:

Here’s hoping we in South Carolina get a shot at purchasing our health insurance through a competitive and transparent market!

By Misty Williams

Saturday, October 22, 2011

As co-owner of a small IT solutions company in Alpharetta, Julie Haley would rather be out networking and snapping up new business instead of spending hours looking for ways to curb her firm’s escalating health insurance costs.

“It really crippled us,” she said, adding that the exorbitant cost meant growing the business more slowly.

Like small businesses across Georgia and the nation, health care costs for Edge Solutions, which Haley started in 2008, have been jumping by double digits. Haley estimates in the first year alone, health care costs made up 25 percent of operating expenses – in part because without at least 10 employees insurers wouldn’t even bother talking with her. Instead, she paid pricey continuation coverage of workers’ prior plans to attract the experienced people she needed who were used to great benefits at larger companies.

Some relief could be on the way, however, with the creation of a small business insurance exchange in Georgia that experts say could reduce costs for employers and increase plan options for workers.

A committee of local health care experts, lawmakers and community leaders is exploring ways to develop an exchange — required starting in 2014 under the federal health care law — and will deliver final legislative recommendations to the governor by Dec. 15. The group is also looking at an exchange for individuals.

While opposing the health care overhaul, Gov. Nathan Deal appointed the committee earlier this year — saying it made sense to study Georgia-based solutions while the courts decide whether the law is unconstitutional. The federal government will step in to set up exchanges if states don’t. Continue reading

Feds Readying To Pick Up States’ Slack, Implement ACA

From The Washington Post:

By N.C. Aizenman, Published: September 10

Across the country, states are lagging in preparations to erect the health insurance market­places at the heart of the 2010 health-care overhaul, bogged down by a combination of partisan hostility and practical hurdles.

Faced with the delay, administration officials have been ramping up talks with state leaders in recent weeks over ways the federal government could pitch in without having to completely take over — speaking both informally and at a series of regional meetings underway.

The private discussions are evolving, with a range of federal-state partnership arrangements under consideration. But analysts on both sides of the health-care debate say one thing appears increasingly certain: The system of 50 completely state-operated insurance markets envisaged by the law is not what Americans will encounter when these “exchanges” open for business in 2014. Continue reading

Feds To Unveil Health-Insurance Exchange Details

From The Wall Street Journal:

Associated Press/Don Berwick, head of the Centers for Medicare and Medicaid Services, will help unveil the plan Wednesday.


Consumers shopping for health insurance will soon get a peek at a new standard form—akin to the nutrition label on food products—that will lay out the details of each policy, from deductibles to how much it might cost to have a baby.

Federal regulators are expected to unveil the proposed summary form, part of the health-care overhaul law, on Wednesday, and the requirement is supposed to take effect next March.”Now, every consumer will have clear, easy-to-read, and concise information that tells them what they need to know,” said Erin Shields, spokeswoman for the Department of Health and Human Services. Officials including Don Berwick, administrator of the Centers for Medicare and Medicaid Services, are scheduled to announce the proposal.
“Now, every consumer will have clear, easy-to-read, and concise information that tells them what they need to know,” said Erin Shields, spokeswoman for the Department of Health and Human Services. Officials including Don Berwick, administrator of the Centers for Medicare and Medicaid Services, are scheduled to announce the proposal.

Currently, states mandate certain disclosures from health insurers, but they vary by state. The information often comes as part of a document known as the certificate of coverage or evidence of coverage, which can run to dozens of densely written pages and is often supplied only after a consumer has signed up for a policy. Employers offering coverage typically provide materials to their workers, but these also don’t follow any common national format.

“It’s very inconsistent,” said Karen Pollitz, a senior fellow at the nonpartisan Kaiser Family Foundation and a former Health and Human Services official.

The proposed new summary is expected to closely follow a draft version from a committee convened by the National Association of Insurance Commissioners, people with knowledge of the matter said. Health and Human Services is expected to finalize the form after a public comment period.

Insurers said they were concerned about the potential cost and administrative burden of the new requirement, particularly if they have to create different iterations of the form for every possible plan design a consumer could explore and for every single employer.

“Some plans would be providing tens of thousands of versions of this document,” said a spokesman for America’s Health Insurance Plans, an industry group.

The summary form has often been compared to the food-nutrition label, though it is substantially longer, and at six pages the draft offers considerable detail. For instance, it would not only tell consumers their overall deductibles, or the amount they must pay before coverage kicks in, but would also explain deductibles for specific categories, such as drug coverage. In addition to flagging the limit on a consumer’s out-of-pocket expenses, the form would lay out which expenses don’t count toward that limit.

A list of medical events and associated services, such as home health care and emergency transportation, would likely be shown along with the consumer’s costs for each. The summary would also explain the consumer’s possible expenses for three common situations: having a baby, treating breast cancer and managing diabetes.

The form would likely be given to people shopping for plans, before they are locked into a selection, by means including insurance agents, email, or websites where policies are sold. Under the health law, it is also supposed to be supplied to workers with employer coverage, when they sign up for plans as new hires or during open enrollment. However, regulators are likely to ask for comment on whether alternative equivalent documents might be acceptable for big employers, people with knowledge of the matter said.

“It would be a big deal to consumers, because they will have a standard way of receiving information,” said Amir Mostafaie, director of quality and training at eHealth Inc., parent company of the online insurance marketplace eHealthInsurance.com.

Research has shown consumers are often confused about the details of their insurance. In a McKinsey & Co. survey of consumers, 72% agreed that health plans are sometimes so complicated it is difficult to understand what is covered or what services cost, according to the consulting firm, which polled around 11,000 people under age 65 late last year and early in 2011. In addition, 57% said that they found the process of choosing health insurance overwhelming.

For insurers, the new form would likely have the biggest sales impact in the individual insurance market, which is expected to grow substantially after 2014, when most of the health-care overhaul takes effect. Already, companies are increasingly focused on how to craft marketing and brand-promotion efforts that will resonate with consumers.

“It’s not an industry that has been consumer-centric,” said Raj Bal, a former executive at insurer WellPoint Inc. who is now an industry consultant. Once it is in effect, the form will likely help shape plan designs and promotion.


Haley To Reject Federal Money For ACA Implementation

From The Spartanburg Herald Journal:

“This is going to mean instead of the fox guarding the henhouse, the fox would be designing the henhouse.” -Rep. Harold Mitchell

By Stephen Largen

COLUMBIA — Gov. Nikki Haley has decided South Carolina won’t pursue any more grant money from the federal health care overhaul to fund a possible state-run health insurance exchange.

“The governor has said she’s going to evaluate these opportunities as they come as to what’s best for South Carolina,” said Tony Keck, the director of the state Department of Health and Human Services. “The one decision she’s already made is that there is no reason for South Carolina to apply for additional money related to health insurance exchanges.”

Keck made the comments on Thursday after the second meeting of the South Carolina Health Planning Committee, a group established by a Haley executive order that’s looking at setting up a state-run health insurance exchange and other opportunities to improve access to and reduce the cost of health care.

A health insurance exchange is an online marketplace where consumers can shop for and compare health insurance policies.

The federal health care overhaul dictates that states must set up their own exchanges to go live when the law goes into full effect in 2014 or have the federal government step in and set up one for them. Continue reading

S.C. Dropping The Ball In Covering The Uninsured

From The Post & Courier:

Panel’s delay could limit health care options

Federally managed insurance marketplace looking likely

By Renee Dudley

Friday, July 1, 2011

COLUMBIA — A panel charged with shaping how South Carolina implements federal health care reform met Thursday but postponed discussion of key decisions — a delay that has some critics worried the state won’t hit federally imposed deadlines.

Members of the S.C. Health Planning Committee, formed by Gov. Nikki Haley’s March executive order, avoided the topic of who should manage the online marketplace where uninsured residents will buy coverage beginning in 2014: the state or the federal government.

The group, which must answer that question and a variety of others related to setting up the so-called “health insurance exchange,” must submit its recommendations to the governor by late October.

If the state has not established its own exchange by the end of next year, officials from the federal Department of Health and Human Services will take over, according to the Affordable Care Act.

The S.C. Health Planning Committee’s delays make it likely the state will default to a federally managed exchange — a decision other states already have made.

Some lawmakers and advocates have said, though, the state should take charge because it could handle residents’ needs more effectively than the federal agency. Some legislators, including Rep. Dwight Loftis, a Greenville Republican, said they bristle at the idea of ceding exchange authority to the federal government — even as they oppose health reform. Continue reading

Healthcare Reform As A Market-Based Solution

From The Huffington Post:

Tommy Thompson– 06/27/11 06:44 PM

I am writing to suggest that governors of both political parties have tremendous opportunity to use free market principles and set up health insurance exchanges which work and give constituents freedom of choice. There is a lot of discussion about health insurance exchanges as it relates to President Obama’s Affordable Care Act. Some governors have a negative opinion of insurance exchanges and I believe that by doing so they are giving up a tremendous opportunity to use marketplace choice and allow insurance companies to compete in their respective states. It would be a terrible mistake to have governors give up that opportunity to set up exchanges and forfeit that opportunity back to the federal government which would limit states’ rights and their constituents’ ability to pick and choose the best insurance for themselves and their families.

Just as governors did during welfare reform, by using these kinds of free market principles to chart a new course in dealing with welfare, they gave people hope for a job and independence and did not lock them into welfare dependency. Exchanges can be and should be a market-based solution. As a Republican and an advocate of market-placed innovation, I believe that health care should possess the same entrepreneurship zeal and leverage of technology that allows us to create an Apple iPhone or Amazon e-commerce portal. Continue reading

Contradicting Surveys Create Public Confusion

From The New York Times:

Douglas Holtz-Eakin headed a group of 105 economists opposed to the ACA

By — June 20, 2011

The debate over the effects of the federal health care law on employer-provided insurance has been intensifying in recent weeks, with controversial polls and consultants contradicting one another about whether employees will benefit or lose coverage by 2014.

Douglas Holtz-Eakin headed a group of 105 economists opposed to the Affordable Care Act.

After nearly two weeks of widespread queries and criticisms, McKinsey & Company, the management consulting firm, posted on Monday the questionnaire and methodology of an online survey it had released that was denounced by the White House and others for contending that nearly a third of employers would definitely or probably drop coverage for employees when provisions of the health care law took effect in 2014. Continue reading

GOP Govs Move To Establish Health Insurance Exchanges

From Politico:

Govs. Walker, Daniels and Barbour are leading on a key piece of the health law. | AP Photos

By SARAH KLIFF | 5/29/11 5:31 PM EDT

A small but growing number of prominent, Republican governors — including Mitch Daniels and Haley Barbour — are taking the lead to shape a key component of the health care overhaul their party fought so hard to kill.

It’s a delicate balancing act for Republicans who, on the one hand, oppose federal health reform, even challenging its constitutionality in federal court, and, on the other hand, are pragmatically trying to control as much of the implementation process as they can.

In Indiana, Gov. Mitch Daniels issued an executive order that allowed the state to become one of just three to receive a multimillion dollar grant to establish a health exchange, the online insurance marketplaces that all states must eventually have if the reform law stands up in court.

Wisconsin, under the leadership of Gov. Scott Walker, is one of six states to win an Early Innovator grant. While the grant was received under Walker’s predecessor, Gov. Jim Doyle, Walker has continued to use the resource, setting up the Office of Free Market Health Care that has prominently advertised its innovator status.

And in a weird twist of politics in Mississippi, state agencies of Gov. Haley Barbour have relied on little-used statutory authorities to set up an exchange, reviving a Democratic-sponsored effort to do so through the Mississippi State Legislature. Continue reading

The Tea Party Vs. Affordable Health Care, Small Businesses

From Politico:
Govs. Fallin, Haley and Deal have taken flack over health insurance exchanges. | AP Photos


By FRANK MICCICHE | 4/26/11 4:39 AM EDT

What does the tea party have against helping small businesses find affordable health insurance for their employees?

Tea party-linked groups have recently spiked legislation in three states that would have authorized federally funded planning to create health insurance exchanges. Activists successfully blocked the efforts of these GOP governors to explore market-based alternatives that would address the stubbornly high ranks of the uninsured in their states. In doing so, they blanketed Republican supporters of this exchange legislation with claims of complicity in the enforcement of “Obamacare.”

The tea party’s success — and the unintended consequences for a constituency with whom they share a number of small government principles — says a lot about the current state of health care policy-making in the states.

Continue reading