Weekly Health Care Wrap-Up.
HHS Officially Extends Exchange Establishment Grant Funding Timetable
The Department of Health and Human Services (HHS) this week officially extended the deadline for states to apply for Level One and Level Two exchange grants. Previously, the final deadline to apply for grant funding was June 15, 2012. HHS’s new deadlines for Level One and Level Two funding range from August 1, 2012 to November 3, 2014. Level One Establishment grantees may apply for additional funding under Level Two Establishment grants once they meet Level Two Establishment criteria. The Period of Performance for Level One Establishment grants is up to one year after the date of award while the Period of Performance for Level Two Establishment grants is up to three years after the date of award.
Senator Snowe Announces Retirement
In surprising news this week, Senator Olympia Snowe (R-ME) announced that she would retire from the U.S. Senate at the end of 2012. Snowe, one of the Senate’s most vocal moderates, is a member of the powerful Senate Finance Committee and the ranking member of the Senate Committee on Small Business. As a regular “swing vote,” Snowe was often in the center of health care negotiations in the Senate and was the only Republican to support the Senate Finance Committee’s version of health reform legislation. Several other members of the Senate Finance Committee have also announced their retirement, including Senators Jon Kyl (R-AZ), Kent Conrad (D-ND) and Jeff Bingaman (D-NM).
CMS Announces Text4Baby Initiative
The Centers for Medicaid and Medicaid Services (CMS) this week announced that it will partner with Text4Baby, a free national health texting service, to promote enrollment in both Medicaid and the Children’s Health Insurance Program (CHIP). Text4Baby, whose partners include the National Healthy Mothers, Healthy Babies Coalition, Voxiva, which provides the mobile health platforms, and a host of wireless carriers will begin by sending more than 184,000 current Text4Baby users a new message alerting them to the availability of free and low-cost health coverage through Medicaid and CHIP. The message will provide a connection to the InsureKidsNow phone number and website for information about how to sign up. Additional messages will be periodically texted to provide Text4Baby users information about the importance of prenatal visits for women and the value of health coverage for keeping children healthy and getting the care they need when they are sick. More information on efforts to enroll children in Medicaid and CHIP is available here.
HHS Releases Actuarial Value Guidance
Late last week, the Department of Health and Human Services (HHS) released guidance regarding the calculation of actuarial values under the ACA. The bulletin sets some federal standards, but also allows for state flexibility in calculating actuarial value. The guidance is available here.
From the States
For full coverage of state exchange activities, check out this week’s State of the States: Health Insurance Exchange Developments here.
HHS Approves Rate Hikes In AK, FL and WA
HHS drew attention this week as media outlets, including Politico, reported that HHS had approved insurance premium rate increases in Alaska (26 percent), Florida (23.3 percent) and Washington (20.4 percent). HHS does not actually have the power to block rate increases under the ACA. However, if HHS determines a rate hike to be “unreasonable,” the insurer must either withdraw the rate and refund its customers or publicly justify the excessive rate.
Vermont House Passes Exchange Legislation
Late last week, the Vermont House passed H559, a bill to create the rules under which Vermont’s health care exchange will operate. In May 2011, Vermont had approved legislation to authorize an exchange, yet that legislation stopped short of defining many important details, including the types of plans that could be offered on Vermont’s exchange and the size of companies that would be required to use it. Passage of the bill was slowed as opponents tried to undo the bill’s requirement that all health care plans sold to individuals or small businesses with less than 50 employees be sold exclusively on the state-run health exchange. These efforts were unsuccessful. Therefore, under the legislation, all plans sold to individuals and small businesses in the state would be sold through the exchange. H559 now heads to the Senate for consideration.
22 Plans Apply to Manage Duals in California
Twenty-two health plans in 10 counties in California have applied to help manage care for dual eligibles under the state’s dual eligible pilot program. Selected plans are expected to be announced by the end of March. All submitted applications have been posted online here.
Health Insurance Exchanges: State of the States update.
This Week in the States. After last week’s excitement surrounding HHS funding announcements, developments for exchanges have returned to the norm.
In her appearance this week before the House Committee on Energy and Commerce, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius was reminded by Representative Joe Pitts (R-PA) that HHS still has not issued many regulations necessary – including guaranteed issue, community rating and final essential health benefits guidance, among others – for states to move forward with exchange development. Sebelius did not give an indication of when states and the industry could expect more details, but did say HHS is “trying to make sure that when [they] release an interim rule and move to a final rule, that these are workable with states.” Late last week, HHS did release its initial guidance regarding actuarial value calculation. That information is available here.
In Oregon, legislation that would allow the state to implement its health insurance exchange was finally passed by the Joint Ways and Means Subcommittee on Capital Construction with two amendments. In its new form, HB4164 will allow certain school districts that currently receive coverage through the Oregon Educator Benefits Board to use the exchange beginning in 2015. Oregon previously enacted legislation authorizing a health insurance exchange in June of 2011.
On the other side of the nation, New Jersey progressed toward passing legislation to create a health insurance exchange after S1319 was approved by the Senate Commerce Committee. Exchange legislation is now waiting for passage in both the House and Senate.
Meanwhile, facing legislative deadlock in his state of Illinois, Governor Pat Quinn is now considering using an executive order to move exchange planning forward in the future. But do not expect a decision soon; Governor Quinn still wants to give the legislature time to act and will likely hold off on making a decision for a few more months.
Finally, in North Carolina, no major decisions were made at Tuesday’s meeting by the Health Reform Health Benefits Exchanges and Insurance Oversight Workgroup (NC HBE). However, the Workgroup discussed reevaluating their current projected annual administrative costs for operating an exchange. Previously, NC HBE estimated that operating an exchange would cost $2.60 per participant and have a cumulative cost of $25.5 million. This differs considerably from an analysis of peer exchanges that budget for administrative costs ranging between $7 and $12 per participant.
Looking ahead, exchange enthusiasts will gather in Washington, DC next week (March 7-8) for the latest in a series of exchange conferences hosted by AHIP. More details are available here.