Individual health insurance reform weekly august 29

Week of August 29, 2011

The Congressional Budget Workplace (CBO) last week released an updated report on the nation's budget and economic outlook that comments on a quantity of health care policy troubles. Very first, the CBO says that if a further physician payment "fix" is enacted by Congress (as has occurred each year given that 2003), then spending on Medicare could be substantially extra than the quantity projected in CBO's baseline. Beneath existing law, Medicare physician payments rates are scheduled to be reduced, but if those rates stayed the identical through 2021 then Medicare outlays over the subsequent 10 years would be $300 billion way more than projected. The CBO also estimates that federal Medicaid spending will raise by much less than 1 percent this year, compared to an typical annual raise of 8 percent in between 2000 and 2009. The slowdown is due to the expiration of elevated federal help to the states for Medicaid in 2009 and 2010. Lastly, CBO is anticipating a one particular-year delay in the implementation of the Community Living Assistance Services and Supports (CLASS) Plan made under the Cost-effective Care Act (ACA). CBO projects the plan won't begin collecting premiums till 2013. Some in Congress have called for repeal of the ACA provision developing the CLASS plan mainly because of its long-term cost.

States  

Aetna participated in one of two "Exchange Listening Sessions" hosted by the Department of Health and Human Services (HHS) for community organizations and nongovernmental stakeholders. The meeting opened with an overview of the Notices of Proposed Rule Creating (NPRM) on Exchanges, Program Standards, Eligibility and Enrollment Medicaid Eligibility and Enrollment and Tax Credits. Comments from advocacy groups basically referred to as for the following:

    Seamless interfacing of the eligibility program for Medicaid recipients, especially the population impacted by the coverage expansion
    Credentials of Navigators (requiring extra from community groups to steer clear of broker dominance)
    Parameters to constrain states from making use of flexibility as a guise to retreat from ACA requirements
    Improved foreign language translations of the material on the HHS web page
    Stricter scrutiny of exchange board membership
    Alignment of Medicaid eligibility/enrollment guidelines with an exchange open enrollment period
    Integrating the exchanges with other public service agencies
    Requiring all carriers to contract with crucial service providers

Joel Ario, Director, Office of Wellness Insurance coverage Exchanges, remarked that the overarching aim of the exchanges was to expand consumer protections by way of higher transparency. His response to issues about adverse choice was to point to the availability of the "young invincible" policy and the "three Rs" -- danger adjustment, threat corridors and reinsurance -- as solutions. Concerning the possible for exchange items to not be reasonably priced, Ario said the objective of the exchanges is solely to expand access and that the price matter will be addressed by exchanges becoming "active purchasers".
 
CALIFORNIA: As expected, consumer groups are threatening to push for a measure on the November 2012 ballot that would let voters choose on no matter whether rate regulation of well being insurance premiums should be allowed. Consumer groups strategy to prepare the ballot language and submit the measure to the state Lawyer General by November. Then the group will start collecting the 700,000 signatures important to qualify for the ballot. Precisely what the ballot language would demand is not but identified, but it would most likely look related to legislation at present pending in the legislature.  The legislation would call for prior approval of all well being insurance rates, payment of intervener charges, approval of employer benefit design modifications and rate rollbacks. Consumer groups seem to be turning their attention toward a prospective ballot measure rather than the legislative vehicle since the bill has come beneath robust opposition from not only health insurers and organization groups but also CalPERS, the League of Cities and the State Department of Finance.