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PWC report reviews exchange progress

Posted on October 4, 2012 | No Comments

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A report recently published by Price Waterhouse Cooper (PWC) examines states’ progress on exchange establishment. The report found that the country, on the whole, is lagging. Only 13 states have decided to create exchanges, while eight have indicated that they will let the federal government take control of exchange establishment. The majority, the report says, are still undecided, and have until November 15 to make a final decision. The PWC report also details typical exchange participants. On average, they are 33 years old, unlikely to have a college degree, and under 200 percent of the federal poverty limit.

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Rhode Island joined an elite rank by becoming one of the first states to release their proposed insurance rates for the 2014 launching of their Marketplace, Rhode Island Health Benefits Exchange. Two insurers have filed to operate on the individual market, and four have filed to offer plans for small employers. The insurance commissioner will begin to review the proposals, and he is expected to either approve, modify or reject the submitted plans by June.
Vermont has released the premium rates of certain qualified health plans (QHPs), which consumers will be able to purchase insurance through Vermont Health Connect, the state's Health Insurance Exchange (Marketplace). Vermont is the first state to release their filed rates for QHPs. The document compares prices between the state's two carriers for both standard and non-standard QHPs.
Yesterday, the Republican Governors Association sent a letter to the White House with requests regarding state-implementation of the Affordable Care Act (ACA). The Republican Governors, who will lead 60% of states starting in January 2013, asked for more time to decide whether they want to establish a state-run health exchange and for a meeting with the administration officials to discuss concerns regarding ACA implementation. Secretary Sebelius of the U.S. Department of Health and Human Services (HHS) sent a letter to all 50 governors immediately following the election extending the deadline for state-federal partnership or federal-run exchange establishment. However, states still must notify HHS by November 16 whether they plan to pursue a state-run exchange. The Republican governors requested more time to finalize their plans. They also posed 20 questions regarding exchange implementation and 14 regarding Medicaid expansion and stated that they would not be able to move forward unless the questions were addressed by HHS.
A report released last week by the Congressional Research Service (CRS) examines the Health Insurance Exchanges under the Affordable Care Act (ACA). The CRS report outlines the required minimum functions of exchanges, and explains how exchanges are expected to be established and administered under ACA. The coverage offered through exchanges is discussed, and the report concludes with a discussion of how exchanges will interact with selected other ACA provisions.
The Centers for Medicare and Medicaid Services (CMS) released a draft letter to issuers regarding Federally-facilitated and State Partnership Exchanges. This guidance letter offers technical and operational guidance that will permit Qualified Health Plan (QHP) issuers to operate successfully in Federally-facilitated Exchanges and Federally-facilitated SHOPs, including State Partnership Exchanges. One specific resource addressing requirements presented in this letter is a database of essential community providers (ECPs). ECPs treat low-income individuals in medically underserved areas. Although non-exhaustive, this database is designed to provide CMS an estimate regarding the number of ECPs in a QHP's service area.
Late yesterday, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius extended the deadline for states to decide whether to run their own exchange until December 14, 2012. The Republican Governors Association (RGA) sent a letter requesting the extension to Sebelius on Wednesday November 14, 2012, just two days prior to the initial deadline. This is the second time in a week that the Secretary has made extensions to key Exchange deadlines, having also recently extended the deadline to submit the state-run exchange blueprint paperwork (also December 14, 2012) and the deadline of whether a state will choose to partner with the federal government on their exchange (February 15, 2013).
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today extended the deadline for states to submit Exchange Blueprint documents, until December 14, 2012. States must still notify HHS of their intent to pursue a state-run exchange by November 16, 2012, but now have an additional month to formally submit the Blueprint. Additionally, the deadline for states to decide on whether to pursue a state-federal partnership Exchange has been extended until February 15, 2013, a full three months beyond the original November 16, 2012 deadline. This decision by HHS should allow states more time to make crucial post-election decisions as to what kind of Exchange they intend to pursue, as well as allow the Administration more time to issue key regulations.
Today, the U.S. Department of Health and Human Services (HHS) announced six new health insurance exchange grant awards. The grants will go to Arkansas, Colorado, Kentucky, Massachusetts, Minnesota, and Washington, D.C. The federal support will aid the states and D.C. in creating the new exchange marketplace. D.C. received $73 million, Massachusetts $41.7 million, Arkansas $18.6 million, Minnesota $42.5 million, Colorado $43.5 million, and Kentucky $4.4 million.
This Update begins with a summary of federal policy guidance on health insurance Marketplaces that has been issued to date. It then presents in its entirety an interview with Gary Cohen, conducted by Professor Sara Rosenbaum of GW on January 29, 2013. The Update concludes with some observations about key issues that will arise as implementation of the federal Marketplace proceeds.
This Update begins with a summary of federal policy guidance on health insurance Marketplaces that has been issued to date. It then presents in its entirety an interview with Gary Cohen, conducted by Professor Sara Rosenbaum of GW on January 29, 2013. The Update concludes with some observations about key issues that will arise as implementation of the federal Marketplace proceeds.
Previous updates have summarized final IRS regulations implementing provisions of the Affordable Care Act that provide premium tax credits to help low- and moderate-income individuals and families buy affordable health insurance through State health insurance Exchanges. The IRS regulations provide that premium assistance tax credits are available to all eligible state residents, regardless of whether their state Exchange is state-operated or federally facilitated. This Update examines a dispute that that has arisen regarding the availability of premium assistance tax credits in federally facilitated state Exchanges.