| Health care spending projections for the next decade, | | | | NEW JERSEY: The Department of Banking & |
| published in the journal Health Affairs last week, | | | | Insurance (DOBI) last week issued a bulletin providing |
| appeared to have a little something for everyone. | | | | template contract riders that insurance carriers can |
| Prepared by Medicare's Office of the Actuary, the | | | | use for the large group market and the (non-reform) |
| report notes that health care spending will increase 0.2 | | | | individual and small employer markets to describe |
| percent faster than previously projected due to the | | | | changes to comply with the Patient Protection and |
| health reform law's many changes to the system. As | | | | Affordable Care Act (PPACA). The rider templates, |
| a result, The New York Times proclaimed that the | | | | which may be used by carriers without submission to |
| "health plan won't fuel big spending," causing an annual | | | | DOBI for formal review or approval, address the |
| spending increase of 6.3 percent rather than 6.1 | | | | following health benefit plan requirements: Extension of |
| percent. The Christian Science Monitor, on the other | | | | coverage to dependents; annual and lifetime dollar |
| hand, warned that reform will definitely cause health | | | | limits; first-dollar coverage of preventive services; |
| insurance costs to rise and that Americans should be | | | | limitations on preexisting condition exclusions; and |
| on guard for big increases in 2014 when many of the | | | | rescissions. A carrier not using the rider template must |
| law's major provisions kick in. Spending on health | | | | submit their own forms for DOBI's formal review and |
| insurance is expected to increase 12.8 percent in 2014 | | | | filing, or approval to bring benefit plans into compliance |
| as millions of uninsured Americans gain coverage. | | | | by September 23, 2011. |
| However one interprets the results of the report, it is | | | | OKLAHOMA: DOI Commissioner Kim Holland and |
| clear that rising health care costs remain unfinished | | | | staff hosted an informational stakeholder meeting last |
| business. | | | | week to discuss the DOI's plans for creation and |
| ARIZONA: The Senate has established an Ad-Hoc | | | | implementation of Oklahoma's exchange under the |
| Committee on the Impacts of Health Care Reform | | | | PPACA. DOI intends to use issue-specific working |
| Implementation. The Committee will hold its initial | | | | groups to manage the task going forward. The state's |
| meeting later this month. The preliminary agenda | | | | online Medicaid enrollment process went live |
| includes: Arizona Health Care Cost Containment | | | | September 7 and processed over 2,000 applications |
| System (Medicaid) requirements; insurance reforms; | | | | with a 60 percent approval rate the first 28 hours. |
| impacts on health care providers; and tax implications. | | | | Over 400 apps came from hospitals that provided |
| Members appointed to the committee include AHIP | | | | overwhelmingly positive feedback. This web tool was |
| retained counsel, clinical and employer representatives, | | | | referenced as a possible "starting point" of the |
| and representatives of the Goldwater Institute, a | | | | exchange's eventual infrastructure. The DOI submitted |
| conservative think tank. | | | | an application for a $1 million Exchange Planning Grant |
| COLORADO: The Division of Insurance (DOI) has | | | | in August and expects to hear a decision from HHS |
| applied for a $1 million health insurance exchange grant. | | | | by the end of this month. If awarded, the money will be |
| If awarded, the funds will be used for research and | | | | used, in part, to hire a consultant to assist with an RFP |
| developing recommendations for implementation of an | | | | to hire a vendor to help build the exchange. Other |
| exchange. Specific areas mentioned include modeling | | | | topics of conversation focused on the more technical |
| on adverse selection, value choices, increasing actuarial | | | | and difficult aspects of building an exchange, such as |
| staff and determining the actuarial effects of benefit | | | | coordinating billing/payment through employers, |
| packages within an exchange and in the external | | | | collecting and reporting data on those entitled to tax or |
| regulated market. The Department of Regulatory | | | | premium credits and cost sharing subsidies, allowing |
| Agencies finalized three regulations that define the | | | | finding/identifying navigators to assist consumers, and |
| standardized electronic identification and | | | | deciding if any additional state benefits/mandates |
| communications systems to be used by all health plans | | | | would be included in coverage. Aetna will stay active in |
| operating in Colorado. The regulations are the result of | | | | this process by serving on future workgroups when |
| 2008 legislation requiring carriers to use systems | | | | appropriate. |
| certified by the Committee on Operating Rules for | | | | WYOMING: The DOI has submitted its plan for a |
| Information Exchange (CORE). Carriers must be able | | | | health insurance exchange grant to the federal |
| to demonstrate their compliance by Sept. 1, 2012. | | | | government. The DOI will use $800,000 to fund a |
| DELAWARE: The Department of Insurance (DOI) has | | | | study, to be overseen by a Governor's task force, of |
| issued a bulletin regarding recently enacted legislation | | | | the feasibility of three exchange options. The options |
| that prohibits rescissions based on medical claims | | | | include (1) operating a Wyoming state exchange, (2) |
| underwriting. The legislation signed into law by | | | | participating in a regional exchange, or (3) allowing HHS |
| Governor Markell on August 30th prohibits rescission, | | | | to run the exchange. This study would occur in two |
| cancellation, or limitation once an enrollee is covered, | | | | phases: phase one would help educate task force |
| except in cases of fraud or intentional | | | | members and consult with stakeholders and experts |
| misrepresentation of a material fact. Effective Sept. | | | | on operating an exchange in the state; phase two |
| 23, 2010, prior approval by the Commissioner or her | | | | would include implementing the recommendations of |
| designee is required before a health insurer may | | | | the task force if it is decided that Wyoming should |
| rescind, cancel or limit existing coverage based on | | | | participate in the operation of an exchange. DOI has |
| written health or medical information. | | | | indicated that no legislative action is necessary to carry |
| LOUISIANA: The DOI has applied for a grant related to | | | | out the duties of the grant, unless the state decides to |
| health insurance exchanges. Aetna, along with the | | | | pursue the operation of an exchange. The white paper |
| Louisiana Association of Health Plans, will participate in | | | | also outlines that several key governmental agencies |
| a meeting with the DOI to discuss the grant and other | | | | will participate in the efforts, which will be facilitated by |
| issues related to health care reform. | | | | the University of Wyoming. |