Monday, September 24, 2012

Summary of Benefits ... Health Insurance, Simplified

Health Insurance, Simplified

Rep Harry Waxman just doesn't understand

Energy and Commerce OKs broker bill

By: Jason Millman – Politico

Posted: September 20, 2012


In the end, Rep. John Barrow found himself all out on his own.

Barrow (D-Ga.), the co-sponsor of a bill shielding agent and broker commissions from the health care law’s medical loss ratio requirement, was the only Democrat on the House Energy and Commerce Committee who voted to advance the bill Thursday. The committee approved the bill on a 26-14 vote.

But it’s likely to have much more Democratic support if it gets to the full House floor.

The agent and broker groups say their livelihoods are threatened by the ACA’s limits on what insurers can spend using premium dollars, besides the actual cost of medical care. By lumping in broker commissions with insurers’ administrative spending, the groups say their members have seen their revenue cut between 20 and 50 percent and have suffered job losses as a direct result.

“This doesn’t just hurt the brokers, but also their employees and, most importantly, the consumers who rely on them to obtain coverage and assistance in understanding the complex health care law,” said Robert Smith, president of the National Association of Insurance and Financial Advisors, in a statement.

Agent and broker groups, framing the MLR as a jobs issue, have made the bill a top legislative priority over the past two years. They quickly gained support in the House with 220 co-sponsors, including about two dozen Democrats — more than most bills altering ACA provisions.

“This should be a bipartisan bill,” said Rep. Mike Rogers (R-Mich.), who co-sponsored the legislation with Barrow.

But the strongest supporters of the ACA have pushed back hard against the bill, contending it would weaken one of the law’s strongest consumer protections. The $1.1 billion in MLR rebates sent out by insurers this year could have been cut by more than half if agent and broker commissions were exempted from the rule, Consumers Union claimed in a report yesterday.

“Commissions have always been recognized as part of administrative costs,” said Henry Waxman (D-Calif.), the committee’s top Democrat.

“This bill would reverse this, causing consumers to pay more for coverage or get less in benefits.”

Democrats on the committee also criticized a provision of the bill that would let states determine whether enforcing the MLR would destabilize their individual or small-group insurance markets.

Governor Dayton Moving ahead on health insurance exchange

Governor Dayton moving ahead on health insurance exchange
By: JACKIE CROSBY - Star Tribune

Posted: September 18, 2012

Dayton ramps up health care exchange plan, reassures GOP foes.

Gov. Mark Dayton told legislative leaders Tuesday that he will seek federal approval to move forward on a Minnesota-made health insurance exchange, but he sought to assure Republican opponents that he will defer important policy decisions until after the November election. Dayton also said he was shifting responsibility for leading the "next phase" of the exchange to a new state agency. The actions are a sign of continued movement to set up a state-run exchange, a key component of President Obama's health care law. The exchanges are scheduled to launch nationwide in 2014 and aim to be competitive marketplaces for individuals and small businesses to comparison shop for health insurance. "While the Affordable Care Act continues to be debated in the political arena, the law is clear: either we design and implement a state-based exchange, or we will be assigned to a one-size-fits-all federal exchange," Dayton said in a letter to the legislators.

More than 1.2 million Minnesotans are expected to be eligible for the exchange, which supporters say will make buying health insurance as user-friendly as shopping for an airline ticket on a travel website.

The state has received $28.5 million in federal grants to hire staff and lay the foundation. It has applied for another $42.5 million to build the technical infrastructure. States have until Nov. 16 to submit paperwork to the federal government to prove they will have a functioning exchange by the Oct. 1, 2013, open enrollment period.

While a Minnesota-designed exchange has the support of the Minnesota Chamber of Commerce and some key Republican leaders, it does not enjoy full bipartisan support. Lawmakers were unable to get an exchange bill out of committee during the previous two legislative sessions, and Dayton has signaled he will use his authority to move forward without legislators, if need be. Dayton seemed to soften that stance in the letter Tuesday, emphasizing in bold type that he would "not commit Minnesota to any final policy decisions in the application," including how the exchange will be financed and whether it will be governed by the state, a nonprofit agency or a combination. "I respect the authority of the Legislature to participate in these decisions, and strongly prefer that we all work together to make these crucial choices," he said. Dayton said he will give the reins to Minnesota Management and Budget to begin scaling up the effort and dealing with what promises to be a more complex and turbulent period where battle lines about how the exchange will work will become more clear. Minnesota Management and Budget Commissioner James Schowalter has served Republican and Democratic administrations.

Until now, Commerce Commissioner Mike Rothman has spearheaded the effort. Brokers and some businesses have raised concerns recently that the process hasn't been transparent enough. Dayton's letter said the move would address concerns that the Commerce Department, which regulates the insurance industry, shouldn't also be involved in building core functions of an exchange it will oversee.

Dayton's chief of staff, Tina Flint-Smith, acknowledged the concerns about conflicts with the Department of Commerce and said, "We listened to that."

Senator weighing health-care exchange options

Senator weighing health-care exchange options  Ohio agrees with Louisiana and says no to an exchange or agrees to a partnership program.  Either way they are unsure how to proceed!

Strict Federal Rules for Health Exchange Data Rankle States

Strict Federal Rules for Health Exchange Data Rankle States Allowing use of IRS data for exchanges ONLY!

Oklahoma Files Suit on PPACA

Oklahoma's attorney general on Wednesday filed a fresh legal challenge to the federal health-overhaul law, zeroing in on penalties that employers in the state would face if they didn't offer affordable health coverage to their workers.

Friday, September 14, 2012

CMS Tele-conference on Exchanges

A Caller on Teleconference for CMS was asking how much money they should ask their legislators for during session to pay for the navigators salary to enroll in an exchange. He wants CMS to pay the salaries for navigators for the first 6 months. This call was from New Mexico.

CMS stated to watch for something called "Market Place Assisters" - more regulations to come out soon. CMS also stated that Agent and Brokers have done a very good job throughout America and will continue to do so.

PPACA: What's Up with the Multi-State Plans? | LifeHealthPro

PPACA: What's Up with the Multi-State Plans? | LifeHealthPro