Empowering patient voices through voter registration
While roughly 83% of adults in the United States will visit a health care provider in the next year, an estimated
News
3-15-12 Affordable Care Act Update
March 16, 2012
Federal Update
On Monday, the Department of Health and Human Services (HHS) released the final regulation on state health insurance exchanges. As expected, the regulation gives considerable flexibility to the states to make the final decisions on rules and procedures critical to an exchange's success of an exchange. The most serious concern in the rule is that it does not clearly require consumer representatives to comprise the majority of an exchange's governing board; however, other areas of the regulation represent improvements from the proposed rule, including network adequacy and patient navigators.
Another troubling issue is the role of independent brokers and "private exchanges" (for-profit internet sites that sell health plans inside and outside the exchange). The regulation states that brokers and private exchanges will be allowed to actively engage in marketing and selling exchange products, but it is unclear how consumer protections will be maintained. ACS CAN and other consumer groups will likely comment on this provision and ask for greater clarification on how consumer protections in the Affordable Care Act will be preserved.
The administration has indicated that related regulations--including premium subsidies, Medicaid changes and the rules for risk adjustments and reinsurance--are likely to be issued in the next few weeks. HHS is also likely to issue an explanation of how the federal exchanges will operate in states that have not established their own exchange by the 2014 deadline. Collectively, these regulations and guidance will constitute the operational foundation for exchanges beginning in 2014.
Please note that a briefing for staff originally scheduled for Friday, March 23 to describe the regulation(s) and answer questions has been moved to Friday, March 30, at which point all of the regulations are expected to have been issued, thus allowing for a more comprehensive overview of the regulatory activity. Additional information regarding the briefing will be forthcoming from Carter Steger.
State Update
Last week, Washington became the first state to choose a benchmark plan that establishes the essential health benefits (EHB) that will be required both inside and outside the exchanges beginning in 2014. The determination was made through the legislative process, with the law specifying that the benchmark plan is the largest (by enrollment) small-group health plan in the state. Most state legislatures will, as happened in Washington, play a role in determining the essential health benefits, if only because the exchange or executive branch lacks the legal authority to decide how the benefits apply to plans outside the exchange.
State insurance commissioners also have a critical role in helping to gather and disseminate information that should be considered when essential benefits are determined. To that end, ACS CAN, as part of the consumer representative group to the National Association of Insurance Commissioners (NAIC), presented the attached information to the full membership of the NAIC at their meeting last week. The two-page document outlines ways that state insurance commissioners can help consumer groups, such ACS CAN, access information needed to better understand how various plans impact cancer care and cancer patients.
NAIC statement on EHB FINAL 2.12.pdf
Litigation Update
All briefs supporting and opposing various provisions of the Affordable Care Act have now been filed at the US Supreme Court. The justices and their clerks will review these submissions in anticipation of oral arguments, which are scheduled for an unprecedented six hours during March 26-28. Extensive media coverage of the case continues, including a recent New York Times article outlining historical context, as well as the importance of the decision to the legacy of Chief Justice John Roberts.
Polling
ACS CAN and several other patient and consumer groups recently participated in a national public opinion poll designed to messaging that supports the establishment of strong health insurance exchanges that will help people with cancer and their families obtain quality, affordable insurance. The poll, which involved both a Democratic and Republican pollster, resulted in several interesting findings:
- Already popular provisions of the Affordable Care Act -- such as the requirement that insurers offer coverage to people with pre-existing conditions such as cancer -- also help to build public support for strong health insurance exchanges.
- The public responds strongly to values-based messaging about the benefits an exchange could offer them, such as the security of knowing that they will have the choice of quality plans, the peace of mind that they won't be discriminated against for having a pre-existing condition, and the control they have in choosing the best plan for them.
- The public responds well to the idea that states can set up exchanges that fit the needs of their residents. A majority of respondents want their state to move ahead to create an exchange rather than wait for the federal government to create one for them.
Attached are two documents that may be helpful in making the case to the public and lawmakers for strong health exchanges that enable cancer patients and their families to experience improvements in their ability to access, choose, and purchase comprehensive health insurance that meets their needs. ACS CAN is working on a more thorough presentation of the findings and will share it as soon as possible.
FINAL.electeds.CommunicationsTips.Exchange..pdf FinalVoters.CommunicationsTips.Exchange.pdf
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families.
Chris Hansen | President
ACS Cancer Action Network | American Cancer Society Cancer Action Network, Inc.