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OK-SAFE, Inc. Reporting
–
Health Insurance Exchange Meeting 12-8-11 Page 1
OK-SAFE, Inc. Reporting
Meeting:
Affordable Care Act Presentation*
Date:
Thursday, December 08, 2011
Time:
10:00 am
Location:
Oklahoma Capitol, Senate Meeting Room 419-C
Speaker:
Kate Richey, of the Oklahoma Policy Institute [who apparently sponsored the meeting.]
Richey:
“
Off the record - i
t doesn’t matter who establishes the exchange or governs it –
it will be run
according to federal requirements.”
“
Utah is working to make their state compliant with the federal law.
”
“
Those are the only two choices available now
–
a state-run exchange, or a partnership with federal government.
”
Regarding the interim study just finished
–
there is one basic fact
–
if Oklahoma establishes a state-run exchange, it has to be basically compliant with the feds.
“
If we do one poorly, we will end up with a federally facilitated exchange anyway.
”
Summary of Kate Richey presentation/commentary on 12/8/11:
Talking points on Medicaid fraud
–
prevention will have to be a sustained effort.
Preventative Care Grants
–
for schools, providers. There are campaigns out there to emphasizescreenings that can
“
prevent health problems.
” (OK
-SAFE Comment: Screenings of non-illpersons is a data gathering mechanism and money-ma
ker for those offering the “service”. )
Access
–
Exchanges are a huge part of making sure people have access to coverage. Mix of carrots and sticks - tax credits, subsidized premiums with a refundable tax credit, but only if theybuy their private coverage through the online exchange. Via online through the exchange willbe the only way people are going to be able to do that. Individual mandate requires that mostadults must have coverage by 2014.
Our health care blog (via website at www.okpolicy.org).
BancFirst
–
pay or play
Temporary high risk pool will automatically go away once the exchanges are in place. Those inthe high risk pool will be rolled over into the exchange.
OK-SAFE, Inc. Reporting
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Health Insurance Exchange Meeting 12-8-11 Page 2
Exchanges
–
“G
oal is to lower prices. No disputing the cost data from the last 20 years. Gottafigure out how to lower their premiums. Exchanges allow people to pool their needs.
”
“
You
’ve
got four plans and they all have to provide certain requirements
–
all gotta be the
same.” Could be s
ame benefits, with different prices or same prices and different benefits.
“
Easier for consumer to compare one plan with another.
”
Requirement for an essential benefitsplan - called a QHP
–
a qualified health plan.
Plan language requirement.
“It’s online, but it’s not just a website. This is a di
fferent thing. What the exchange needs to beable to do is access both public coverage and private coverage. As life changes occur, you needto be able to go online and make those changes.
”
Should be able to pay online and receiverefundable tax credit online. It will have a very sophisticated back office system.
24-hour online support to help people buy coverage.
For a state run exchange to be compliant it must be federally compliant.
Compared Utah stats to Oklahoma stats
–
Utah healthier. (Did not elaborate on source of statsor mechanism for rating).
Utah is working to make their state compliant with the federal law.
Question from attendee on the governance of exchange.
Richey - No opinion on which form is best. Wait until the state moves forward with legislation.Each model has their pros and cons.
“
We need to take action and move forward.
”
On Feb. 29, 2011 the federal government issued some answer in the form of Q & A on StateExchanges. Is OK ready to run an exchange by Jan. 2013? The exchanges have to launch by2014, so has to be
“
beta ready
”
by Oct. 2013.
Regarding states not being ready
–
“the
feds are willing to meet you where you are and walkwith you through the exchange. If we turn down establishment grants, there is money still outthere. If we miss the deadlines will the funds will still be available.
Question about grants - Yes, they will be available on a rolling schedule through 2014.
Check offs1.
background research
–
know the markets2.
How many insurers can they handle the requirements3.
Stakeholder consultation
Question - Where is the advocate in Oklahoma for the exchanges? Seems like we got derailed
by the Tea Party they just didn’t want
the state to comply.
“We’re working on the governance structure.”
Not sure why the money was returned. Will have to reapply for another establishment grant
Comment from attendee - NAHU (National Association of Health Underwriters) are behind(advocate) it. The OHCA working groups are active. We were sad to see those funds return.The Tea Party blocked it.
There were groups there at the beginning, various advocates.
Feds will set up exchange if they need to, but they
don’t want to run it for long run.
Willeventually turn it back over to the states for most of the functions. (Except data hub?)
Grant agreements come with benchmarks that must be achieved.
“
Even if we miss the deadlineson these grants the money will still be available until 2014.
”
As far as Richey knows no one has
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