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Will the Roll Out of the Affordable Care Acts Health Insurance Exchanges Be Delayed
While the Governors Mansion in Pennsylvania is currently under the control of the Republicans, the Disease Management Care Blog knows the states Insurance Department is relatively apolitical. Thats why this September statement by Pennsylvania Commissioner Consedine before the U.S. House Ways and Means Subcommittee on Health is quite telling.
In it, Mr. Consedine describes how the Keystone state is encountering difficulties implementing an health insurance exchange. As DMCB readers will recall, exchanges are a key feature of the Affordable Care Act, because theyll provide an online market that will enable individuals to obtain coverage.
According to Mr Consedine, CMS is failing to support a good law with the many regulatory details that turn a vague idea into a functioning reality. These failings include:
1. "Interim," not "final" rules on eligibility, tax credit calculations, cost sharing and the role of brokers
2. Little formal guidance on the determination of the essential health benefit.
3. Delays in issuance of regulations on how states and Uncle Sam will split or mutually indemnify the myriad costs of the exchange and the Federal Data Hub.
4. Delays in the issuance of regulations on how states can exit a federally run exchange to set up one of their own.
5. Lack of clarification of CMS impact on insurance markets operating outside the exchanges.
6. Little understanding of whos in charge of consumer protection statutes.
7. Confusion over reconciliation of multiple states insurance laws and regulations in multi-state exchanges.
8. No guidance on how to roll long-extablished and well functioning state-subsidized insurance programs into the exchanges.
9. Concern that funding of the information technology could be clawed back if Medicaid eligibility does not meet CMS criteria.
10. Little guidance on whether exchanges will need to provide consumers with a list of providers who are accepting new patients.
The concerns are also damning in the context of the the normal tug of war between the states and Washington DC. Thats because in his testimony, Mr. Consedine states he wrote to HHS weeks ago and has not received a reply. While its not unusual for the Feds to stiff politically inconvenient inquiries, the Disease Management Care Blog is fearful that the reason why HHS seems unwilling to provide a timely reply is because it doesnt know the answers.
If Pennsylvanias experience is typical, that means the roll out of the exchanges could be significantly delayed.
You read it here first.
9/26/12 Update: Senator Hatch agrees with the DMCB
Will the Roll Out of the Affordable Care Acts Health Insurance Exchanges Be Delayed
Wednesday, February 5, 2014
While the Governors Mansion in Pennsylvania is currently under the control of the Republicans, the Disease Management Care Blog knows the states Insurance Department is relatively apolitical. Thats why this September statement by Pennsylvania Commissioner Consedine before the U.S. House Ways and Means Subcommittee on Health is quite telling. In it, Mr. Consedine describes how the Keystone state is encountering difficulties implementing an health insurance exchange. As DMCB readers will recall, exchanges are a key feature of the Affordable Care Act, because theyll provide an online market that will enable individuals to obtain coverage.
According to Mr Consedine, CMS is failing to support a good law with the many regulatory details that turn a vague idea into a functioning reality. These failings include:
1. "Interim," not "final" rules on eligibility, tax credit calculations, cost sharing and the role of brokers
2. Little formal guidance on the determination of the essential health benefit.
3. Delays in issuance of regulations on how states and Uncle Sam will split or mutually indemnify the myriad costs of the exchange and the Federal Data Hub.
4. Delays in the issuance of regulations on how states can exit a federally run exchange to set up one of their own.
5. Lack of clarification of CMS impact on insurance markets operating outside the exchanges.
6. Little understanding of whos in charge of consumer protection statutes.
7. Confusion over reconciliation of multiple states insurance laws and regulations in multi-state exchanges.
8. No guidance on how to roll long-extablished and well functioning state-subsidized insurance programs into the exchanges.
9. Concern that funding of the information technology could be clawed back if Medicaid eligibility does not meet CMS criteria.
10. Little guidance on whether exchanges will need to provide consumers with a list of providers who are accepting new patients.
The concerns are also damning in the context of the the normal tug of war between the states and Washington DC. Thats because in his testimony, Mr. Consedine states he wrote to HHS weeks ago and has not received a reply. While its not unusual for the Feds to stiff politically inconvenient inquiries, the Disease Management Care Blog is fearful that the reason why HHS seems unwilling to provide a timely reply is because it doesnt know the answers.
If Pennsylvanias experience is typical, that means the roll out of the exchanges could be significantly delayed.
You read it here first.
9/26/12 Update: Senator Hatch agrees with the DMCB
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