New York Gets Go-Ahead To Set Up Insurance Exchange By Jerry Zremski Buffalo News Washington Bureau Chief December 14, 2012
WASHINGTON - The federal government Friday gave tentative approval to New York's efforts to set up a health insurance exchange where uninsured New Yorkers and small businesses will be able to shop for policies starting next October. The state has met the benchmarks it needs to meet in setting up the exchange, officials at the Department of Health and Human Services said. "New York has made significant progress, and in 10 months will be ready for open enrollment where New Yorkers will be able to purchase private health insurance plans," said HHS Secretary Kathleen Sebelius. The creation of the state health insurance exchange may mean little to New Yorkers who currently get health care through their employers, but it will mean a lot to the uninsured, said Chiquita Brooks-LaSure, director of coverage policy programs at the federal government's Office of Health Reform. "It will be a one-stop marketplace where people can find the health plan that meets their needs," Brooks-LaSure said. That's something people will have to do starting in 2014 when, under the Obama health law passed in 2010, most Americans will be required to have health insurance. New York will be ready when that day comes, said Donna Frescatore, executive director of the New York Health Benefit Exchange. The exchange already has a website, http://www.healthbenefitexchange.ny.gov <http://www.healthbenefitexchange.ny.gov/> . And starting in January, the state will begin working with insurers that are interested in offering insurance policies on the exchange. And starting on Oct. 1, 2013, individuals and small businesses will be able to start shopping for insurance on the exchange. In-person "navigators" will be available around the state next fall to help people navigate the exchange, Frescatore added. New York is one of only 18 states that has opted to set up its own exchange. "We want to make sure the exchange is well integrated with our public health insurance programs; we want it to be a seamless process," Frescatore said. "We also wanted to make sure the exchange was designed to meet the needs of small businesses." New York has received $183 million in federal grants to set up its exchange. In contrast, many states - particularly those with Republican governors - have instead opted to either let the federal government run such exchanges or have set up a federal-state partnership. Some states have worried that a state-run exchange eventually would be a costly burden on state taxpayers. "If Virginians are faced with running a costly, heavily regulated bureaucratic exchange without clear direction from Washington, then it is in the best interest of our taxpayers to let Washington manage an exchange at this time," Virginia Gov. Bob McDonnell said Friday in a letter to Sebelius.
Most Governors Refuse to Set Up Health Exchanges
By Robert Pear New York Times December 15, 2012
WASHINGTON - The Obama administration said Friday that more than half the states had rejected its pleas to set up their own health insurance exchanges, dealing a setback to President Obama's hopes that Republicans would join a White House campaign to provide health insurance to all Americans.
Friday was the deadline for states to notify the federal government of their plans, and administration officials had been hoping that Mr. Obama's re-election would overcome resistance to the new health care law.
Federal officials said they knew of 17 states that intended to run their own exchanges, as Congress intended.
Two of those states, New York and Kentucky, won conditional federal approval on Friday for their plans to create and run state-based exchanges. Kathleen Sebelius, the secretary of health and human services, also approved an application from the District of Columbia.
In seeking federal money, New York estimated that one million people could obtain insurance through its exchange. In addition, said Josh Vlasto, a spokesman for Gov. Andrew M. Cuomo, the exchange will lower the cost of coverage for many New York businesses.
But in Virginia, after more than a year of planning and research, Gov. Bob McDonnell said his state would not operate its own exchange. "Despite repeated requests for information, we have not had any clear direction or answers from Washington until recent days," Mr. McDonnell said.
On Monday, Ms. Sebelius gave preliminary approval to state-based exchanges being established by Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington.
The exchanges are online supermarkets where people can shop for private health insurance and obtain federal subsidies to help defray the cost. The Congressional Budget Office has estimated that 25 million people will eventually receive coverage through the exchanges.
Federal officials and federal contractors will set up and run the exchange in any state that is unable or unwilling to do so.
Gary M. Cohen, a federal health official, said the administration "has encouraged states to establish their own exchanges." But, he added, consumers will have access to affordable health insurance in all states, regardless of who is in charge of the exchange.
The concept of an exchange is simple: Competition will drive down prices. But operating an exchange is an immense technical challenge requiring sophisticated information technology to digest and display huge amounts of data on the costs and benefits of various insurance plans.
The federal government and states face a series of deadlines in the new year. On Jan. 1, Secretary Sebelius must determine whether each state will be able to operate its own exchange in compliance with federal standards. By Feb. 15, states must notify the federal government if they want to help with selected tasks, like consumer assistance and the supervision of health plans, in partnership with the federal government.
On Oct. 1, consumers can begin to enroll in health plans, for coverage starting on Jan. 1, 2014, when most Americans will be required to have insurance.
Administration officials said they were delighted this week when a Republican governor, C. L. Otter of Idaho, announced plans to establish a state-run exchange.
However, Mr. Otter's rationale provided little comfort to the administration. He said he did not want to surrender power to "federal bureaucrats." He denounced "the mandates and overreaching federal authority of the Affordable Care Act." He said the law "will do little or nothing to reduce costs while force-feeding us coverage and increasing the size and scope of government." And he said his decision could be rescinded if the State Legislature disagreed with him.
Pennsylvania seriously considered running its own exchange, but Gov. Tom Corbett said on Wednesday that he would not pursue the idea.
"State authority to run a health insurance exchange is illusory," Mr. Corbett said. "In reality, Pennsylvania would end up shouldering all of the costs by 2015, but have no authority to govern the program."
In Tennessee, state officials did a huge amount of planning for a state-run exchange. But Gov. Bill Haslam announced this week that he had decided against the idea because the Obama administration had failed to answer numerous operational questions.
Gov. Chris Christie of New Jersey cited similar concerns in vetoing legislation to establish a state-based exchange last week.
"New guidance continues to trickle out of Washington at an erratic pace," Mr. Christie said.