Health Insurance Exchange Update: Wednesday, July 11, 2012

Nevada State Flag

Today, the House will vote on repealing Affordable Care Act. This will not be the first time the House has voted to repeal this according to the Washington Post. This has occurred 32 times already, this will be number 33. There are however those in state offices who are electing to take action or gather all the information to figure out the full implications regarding the exchange marketplace.

The letter sent to 12 Senators and 61 House Members minutes after the health care law was upheld was signed by those who opposed it, Nevada elected not to sign the letter. As one of the 26 states that challenged the constitutionality of the law, Nevada will go ahead and begin to set up health insurance exchanges. Gov. Brian Sandoval moved forward with implemented the law his first day in office back in January of 2011. The governor expressed some concern over the constitutionality of certain parts but he realized that as long as the law is enacted, there were deadlines to meet. Nevada was awarded approximately $24.7 million in grants for to set up the exchanges. Nevada’s exchange is set to be operational by October of 2013. 

Gov. Mark Dayton of Minnesota sent a letter to Republican legislators to ask them to participate in helping create health insurance exchanges. However, a key senate leader wants to wait until the November election to begin implementing the provisions in the healthcare law. Gov. Dayton wants to urge state officials to act on this provision now or they will be forced to having to use exchanges set up by the federal government. But there are still proponents of the bill who want answers. Sen. David Hann wants to know how this is going to be affordable. Sen. Hann believes that exchanges will cost anywhere from $300 million to $400 million per year. Regardless of the opposition, the governor will be trying to move forward. 

Idaho Gov. Butch Otter wrote an op-ed piece sent out to various media outlets explaining that he will get all the facts about the exchanges before he does anything. He does not want to join other GOP governors who will continue to fight against the law and hope for a Mitt Romney win in November. But as Otter expressed in his piece, he wants to do what’s best for his constituents. 

Maryland’s governor, Martin O’Malley, is on track to establish the state run exchanges according to Youth Today. The early action taken by the governor has led to the creation of Maryland Health Benefit Exchange as a public corporation back in April 2011. Maryland Legislature approved policies for the state run exchanges. 

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate! 

Health Insurance Exchange Update: Tuesday, July 10, 2012

Delaware State Flag

House Republicans are going to vote on the Patient Protection and Affordable Care Act tomorrow. It will most likely be ruled in favor of repeal but they need the Senate. The House’s motion will be dead on arrival. Besides the battle still being waged on Capitol Hill, there is a state that is having internal issues.  

Missouri's state officials are arguing over the semantics of their ballot summary. The state are holding a vote in November on a bill that would stop Democratic Gov. Jay Nixon from setting up health insurance exchanges without the consent of state legislature or state voters. So now the Lt. Gov. Peter King said that he will file a lawsuit citing that the summary is biased.

So with staunch opponents of the bill will wait until the November election to do anything and a state fighting amongst themselves, other states are beginning to set in motion their own exchanges. 

In Indiana, JA Benefits, a benefits provider, has begun creating their own health insurance exchange. Called JA Exchange, the exchange will help individuals compare options. The exchange will receive quotes in seconds by filling in the right information. Private exchanges like JA Exchange will be the force in the marketplace. 

Kansas seems to be in a bit of a bind with the outcome of the ruling according to Kansas Watchdog. Gov. Sam Brownback decided not to accept the $31.5 million provided by the federal government to establish exchanges. He and 22 other governors involved in the lawsuit against the bill banked on the Supreme Court striking down the law. And that did not work out too well. So now what? That is the question the governor is up against at the moment. A scramble would be on to create the exchanges themselves but the Head of Insurance Department Accident and Health Division Linda Sheppard believes that there are three choices to be made. One choice is to use the amount of time they have left to set up their own exchanges. There second choice is to cut a deal with the federal Health and Human Services regulators. With this, the federal government will set the rules and then Kansas would enforce. The third choice is to allow federal regulators to run the exchanges. 

Delaware has one foot in and one foot out. Democratic Gov. Jack Markell is unsure whether they want to expand Medicaid in their state. And since the Supreme Court ruled that the government could not withhold money if a state does not expand Medicaid, the state is weighing their options. As far as setting up the exchanges, the process is underway. But because of the state’s small size, it intends to have federal regulators take over operational duties. 

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!

MDRP Spotlight Video: Current Civil and Criminal Enforcement Activities to Improve Corporate Compliance

Last year at the Medicaid Drug Rebate Program 2011, Viveca D. Parker, Assistant United States Attorney, United States Department of Justice, F. Elizabeth Lepic, Assistant Attorney General, MFCU, Office of Attourney General,  Virginia A. Gibson, former Executive Assistant U.S. Attorney for the Eastern District of Pennsylvania Litigation, Arbitration and Employment Practice Group, Hogan Lovells US LLC presented "Current Civil and Criminal Enforcement Activities to Improve Corporate Compliance."

In their discussion, they look at the current state of Medicaid Fraud and current enforcement activities from the Fraud Enforcement Recovery Act and other issues and reasons why the government starts investigations into Pharma companies.



This year at MDRP 2012, Marilyn May, Healthcare Fraud Coordinator, Assistant United States Attorney, United States Department of Justice and returning speaker Virginia "Ginny" Gibson, Partner, Hogan Lovells , LLP will be on hand to present the current state of legal enforcement in 2012, "Current Criminal and Civil Enforcement Activities to Improve Corporate Compliance."  For more information on this presentation and the rest of the program, download the agenda.  If you'd like to join us this September for the event, register today and mention code XP1725BLOG and save 25% off the standard rate!

Health Insurance Exchanges Update: Monday, July 9, 2012

Arizona State Flag

Now that the law has been upheld, there are still some mixed feelings among politicians. Described in a write-up in the New York Times, state officials opposed to the law are turning their attention to the exchanges. Critics are trying to figure out if subsidies are still offered if a state fails to set up their own exchanges.

And now that there will be a vote on the bill in the House this coming Wednesday, critics of the bill are trying anything to strike down this law. 

In New York, Gov. Cuomo said that he is not open to revisiting health insurance exchanges according to the New York Daily News. The statement came after Republican State Senate Health Committee Chairman said that there may be legislative approval to set up the exchanges. This is relatively odd since the GOP decided not to pass a bill and when Cuomo decided to use his executive order, there
 were no objections.
 

In Arizona, the idea of health exchanges is still left for grabs according to the Arizona Capital Times. House Speaker Andy Tobin said that he would like to wait for the November election to set up the exchanges. But the Gov. Jan Brewer has decided to go the other way on this. Arizona has taken $30 million to startup the state run exchanges. Her administration had been setting up their own exchange for months but to try and persuade legislatures will be a difficult task for the governor. But by the looks of the work of the governor, she does not want the federal government to have their exchanges in Arizona.

 

In Texas, Governor and former Republican presidential hopeful Rick Perry made his stance crystal clear when he issued a statement to the U.S. Health and Human Services Secretary. Under the law, if a state refuses to set up the exchanges, they will instead have to use the plan the federal government has set up. As for the expansion of Medicaid, the Supreme Court found it unconstitutional for the government to withhold money if it is not used to expanding Medicaid. So according to the Houston Chronicle, Rick Perry like so many others have decided not to do anything regarding setting up exchanges or expanding Medicaid in his state. Perry believes that state exchanges nor Medicaid expansion will result in affordable care.

Oklahoma is doing the exact same thing when it comes to rejecting the exchanges, according to the NewsOK. Directly after the health care ruling, Rep. Michelle Bachman and Senator Jim DeMint sent a letter out to the National Governors Association telling them to not implement any of the provisions in the health care law. Sen. Tom Coburn of Muskogee in Oklahoma was one of the many state officials who signed the agreement. Reportedly, he told the co-chairman of the legislative committee back in 2011 to look into setting up an exchange program reminiscent of Utah’s. But Coburn had a change of heart and said that the state not starting up exchanges is not a cause for concerns. Governor Mary Fallin however, has not decided on what to do exactly with exchanges and Medicaid expansion. Though not a fan of the exchanges, she did at one point in time accept the money to start up an exchange program but nothing has been done since.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!

Where do governors stand on the expansion of Medicaid?

The one part of the Affordable Care Act that was struck down was the automatic expansion of state's Medicaid or being penalized by the government. Healthwatch recently profiled where state governors stood on the matter. There have been seven Republican governors that have said no: Florida, Iowa, Kansas, Louisiana, Nebraska, South Carolina, and Wisconsin. Many of those governors, in addition to the eight who seem unlikely to expand, believe it will cause significant distress to their states budgets. In the original form of the Affordable Care Act, the government would have subsidized the expansion of Medicaid for several years. The states that have confirmed they will expand Medicaid are California, Connecticut, Hawaii, Illinois, Massachusetts, Minnesota, Maryland, New York, Oregon, Rhode Island, Vermont and Washington.

This expansion - or lack thereof - has a direct impact on pharmaceutical manufacturers' bottom lines. The number of people who will be added to the Medicaid program will significantly impact the rebates and reimbursement sector. At the 17th Annual Medicaid Drug Rebate Program Summit, not only will the leaders from the major pharmaceutical manufacturers be in attendance to discuss how they are anticipating the expansion, but many states, including Florida, Illinois, Oregon and and North Carolina will be on hand for face to face discussions.  For more information on the program, download the agenda.  If you'd like to join us in Chicago September 10-12, 2012 in Chicago, as a reader of this blog when you register and mention code XP1725BLOG, you'll save 25% off the standard rate.

What does the exchange actually look like?

Yesterday at NPR, host Melissa Block sat down with Adam Weil, executive director of the National Academy for State Health Policy. They discussed the current state of health exchanges and what they'll look like. They cover how the exchanges will be set up and the dynamics of the exchanges.  They also discuss how stats will have to manage the exchanges - whether or not they have begun creating them.

Listen to the podcast here:




This fall at the Health Insurance Exchange Conference, learn directly from the
states and plans with the most experience in exchanges as they share best practices and lessons learned, which will speed up your exchange strategy so market share is secured from the outset. HIX will take place November 13-14, 2012 in Chicago, IL. For more information on this program, download the agenda. If you'd like to join us, register today and mention code XP1710BLOG and save 15% off the standard rate!

Health Insurance Exchange Update: Thursday, July 5

Virginia State Flag

In today's update, we see many states putting off the exchange. We also see how other professionals such as accountants are directly affected by the law. To see the progress of each state exchange, visit Kaiser's Health Reform Source.

In Maine, there is no strategy to create an exchange before 2014.  The Bangor Daily News believes that the state will ultimately have to rely on the federal exchange.  This opinion piece urges the state law makers to begin looking into an exchange, as they believe a federal exchange would not take into account many of the state-specific healthcare demographics such as small businesses.

Virginia has created a committee Sen. Richard Stuart, R-Stafford, was appointed to Virginia Health Reform Initiative’s advisory council, along with Joe Wilson, a Fredericksburg businessman. According to Fredrickburg.com, they've been working with everyone affected (including insurance companies, businesses, advocacy groups, patients’ rights groups, doctors, hospitals) in the state to develop an action plan for the exchange. They believe they have the bare skeleton to the future exchange.

There will be a new face of the law according to Accounting Web.  CPAs will be put in the center of healthcare reform.  Every income tax the prepare will now have to include the question "Do you have health insurance?"  They will be the ones adding the line item of the tax and will ultimately be put at the center of political discussions, which CPAs have never had to deal with before.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!

Health Insurance Exchange Update: Tuesday, July 3, 2012

Florida State Flag

In an effort to exercise their ability to be the uncooperative partner, 12 senate and 61 House members sent out letters to governors telling them to rebel against the Affordable Care Act. One man in particular is taking this to heart where as some are weighing options and very few are ahead of the curve. 

Florida Gov. Rick Scott stated soon after the health care ruling said he rejected health insurance exchanges. Now the governor has come out and said that he will also not be expanding Medicaid as well according to The New York Times. The governor cites that the state will have too much of a burden expanding Medicaid for his citizens. Even though the government will cover all costs for new people under Medicaid from 2014 to 2016, he believes that after those three years the tax payers will have the burden of paying a substantial amount. But there are some who have begun to critique what exactly Scott said while making his rounds on national television. Whether it is from the amount of money Florida will pay to the idea or rationing of the health care, there are some regarding his comments as false on off base with what the health care law actually does. 

North Dakota is one of 36 states that must decide whether or not to take the lead in creating health insurance exchanges, according to the Jamestown Sun. Their legislator decided to have the federal government lead them in establishing exchanges. Under the current deadlines, North Dakota may not have enough time unless they receive conditional approval from the government. Blue Cross Shield of North Dakota are exploring the possibility of having a standby template incase the government offers an extension. But if the state is not offered an extension, then the state will have to use the federal government’s exchange program. 

Gov. Chris Christie of New Jersey is deciding whether or not he will also use the federal government in order to set up exchanges, claiming that this would be good for the state. He has also mentioned that Medicaid in New Jersey is already inclusive and that the federal government should give money to states for Medicaid with no strings attached, according to NECN.

Taking the initiative into his own hands, New York Governor Andrew Cuomo decided to use an executive order in order to comply with the health care law back in April. Now they are one of the few states ready for when most of health care law goes into act in 2014. Of the 2.7 million people who are uninsured, 1 million will be able for exchanges, 700,000 are immigrants who will not be covered and the remainder will receive Medicaid coverage according to Democrat and Chronicle.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!

Continued Uncertainty after ACA Ruling: Questions remain but IIR's healthcare events offer answers

Following the Supreme Court’s historic ruling on June 29th on the Patient Protection and Affordable Care Act, some very important questions still remain that affect all sectors of the healthcare and life science industries. IIR’s 2nd Annual Health Insurance Exchange Congress and 17th Annual Medicaid Drug Rebate Program Summit will delve into these important questions.

As a whole, the ACA was kept almost entirely intact, meaning health insurance exchanges will be a large part of the future healthcare landscape. There are still questions about how different state-run exchanges will look, what the federally-facilitated exchange will look like, and how everyone can get exchanges running by 2014. At the 2nd Annual Health Insurance Exchange Congress state officials with first-hand experience building exchanges will share their insight. Health plan executives who have experience crafting and implementing financially sound benefits for exchanges will share what works and what doesn’t when competing on an exchange.  If you'd like to join us in Chicago November 13-14 for this event, as a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll save 10% off the standard rate!  For more information on this event, download the agenda.

One provision of the ACA was restricted, which could mean the difference in billions of dollars to the federal government, each state government and the pharmaceutical industry. SCOTUS’s opinion says, “the Medicaid expansion violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion.” This decision gives states some flexibility not to expand their Medicaid programs, without paying the same financial penalties that the law called for. What is uncertain, is which states will choose to expand Medicaid and which won’t, meaning how many Americans will be added to the Medicaid program, and how much more rebating will branded and generic manufacturers have to do?

According to the Kaiser Family Foundation, if all 50 states participated in the program, in aggregate, between 2014 and 2019, they will spend $21.1 billion to extend Medicaid, while the federal government will spend $443.5 billion. But if some states choose not to participate in the expansion, the cost to the federal government is still very uncertain. The cost to the pharmaceutical industry, is also hard to estimate. At the 17th Annual Medicaid Drug Rebate Program Summit, expert industry analysts, federal and state government representatives, and pharmaceutical executives will be on hand to discuss what the ACA means for each segment of the industry, and how it will affect bottom lines.  Don't forget, as a reader of this blog, when you register to join us this September 10-12 in Chicago and mention code XP1725BLOG, you'll save 25% off the standard rate!  For more information on this event, download the agenda.

Health Insurance Exchange Update: Monday, July 2, 2012

Well, it is now official, the President’s Affordable Care Act (ACA) was found constitutional by the highest court in the land, the Supreme Court. But, many across the aisle still do not believe this is true. So, instead of living with this ruling, Republicans in the House will vote on July 11 to repeal (ACA). State officials are protesting as well, waiting and hoping for a Romney win. But, November 16 is the deadline to submit a plan to the Department of Health and Human Services. So there wishful thinking may not end well for them.

Kansas seems to be torn in two separate directions according to Ark City. Kansas Insurance Commissioner Sandy Praeger is at odds with other Republicans in her state to setup the health insurance exchanges. Gov. Sam Brownback wants to delay the setup of exchanges until after the November election. Kansas has not done anything to go forward with some plan. They went so far as to reject the millions of dollars in aid in order to finance the project. Stephen McAllister, who once served as a clerk for Clarence Thomas, said that this wishful thinking by Republicans is a far stretch. If Romney is actually elected in November, he needs Congress in order to overturn the (ACA). So with that being said, there needs to be a Republican Senate and House just to get the right number of votes and while they are waiting for all that to happen, here it will be 2014 when everything goes into effect.

Idaho is in a tight bind after the Supreme Court ruling according to CBS News. The state rejected the $20 million in grants in order to establish the exchanges. They were banking on the ruling of the health care ruling but now that it has been ruled constitutional, Idaho now has to figure out what it will do next in order to comply with the federal government. The state will need lenience from the federal government and quick action in order to meet the November 16 deadline. With little time to set up their own exchanges, the state will have to use the federal government for support.

Michigan is now deciding that they will take their medicine and establish the exchanges according to Detroit Business. Michigan House Speaker Jase Bolger said that the state will move forward with implementing the healthcare law. Gov. Snyder said he will sign bill to allow Michigan to operate its own exchange. However, the Attorney General Bill Schuette said he too wants to wait until the November election.

But there is someone who has a plan. 

Montana will now be moving forward with the implementation of the after the ruling of the Supreme Court according to Great Falls Tribune. Montana insurance commissioner Monica Lindeen said that the state will help the U.S. Department of Health and Human services to establish Montana’s health insurance. This coming after Republican-led state legislature to help design Montana’s own plan was rejected last year. 18 percent of uninsured people in Montana will now be able to buy coverage from private insurers with the help of state-run exchanges.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!