Last week, the National Association of Insurance
Commissioners held a first of many planned
meetings on health care reform. In
many ways, state insurance commissioners, have become the front lines of health
reform implementation as they are responsible for ensuring that health plans
are compliant with the insurance reforms in the Affordable Care Act and they
will play a key role in the establishment of the exchanges.
For this meeting, at the top of the agenda was the
exchanges and the discussion ran the gamut, from basic questions about exchange
responsibilities to detailed analysis of how to limit adverse selection. The
consumer perspective was well represented with our colleague at the Georgetown Health Policy Institute, Sabrina
Corlette, who testified along with Tim Jost of Washington and Lee University.
Tim shared his view that the success of an exchange will depend greatly on its
ability to establish a streamlined enrollment and eligibility system that is
seamlessly linked to Medicaid and CHIP.
Interestingly, the issue of coordination between the
exchanges and Medicaid and CHIP brought forth many questions from the
represented commissioners. More than once we heard reference to the fact that
public programs, and the populations they serve, are a new world for insurance
commissioners and that they are eager for more information. Key issues on their
minds were how to maintain continuity of care between those moving back and
forth between exchange and Medicaid/CHIP coverage, what IT funding and/or
technical assistance will be available to assist Medicaid/CHIP agencies, and
how to align the more “prescriptive” eligibility rules of Medicaid/CHIP with
the tax credits so that enrollment in exchanges is consumer friendly.
The conversation was a good start – but also a good
opening for ongoing dialogue with and education to state insurance commissioners
on the central role that exchanges will play in helping people to secure
subsidies for coverage and in facilitating their enrollment into Medicaid and
CHIP. Georgetown CCF submitted comments to the NAIC on these critical issues.
For the meeting agenda and other materials, visit the NAIC site.