Health Care Implementation Details Discussed at the NAIC

Insuring Resources Commentary:

As I've mentioned I'm a member of the Wisconsin Insurance Commissioner's Health Insurance Advisory Council. Our next meeting is April 13 and I expect the issues detailed in the article below will consume the majority of our agenda and discussion.

As the article states implementation of health care reform is going to be job 1 for insurance commissioners over the next five to ten years.

I'm looking forward to aiding in the implementation.


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Health Care Implementation Details Discussed at the NAIC

By ALLISON BELL
National Underwriter

State regulators tried to get an idea of how big is big this past weekend as they talked about implementing the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act.

President Obama created years–and possibly decades–of work for state insurance regulators, state health regulators, and the National Association of Insurance Commissioners, Kansas City, Mo., when he signed the bills creating PPACA and HCERA into law.

Policy experts are just starting to dig behind the act summaries and read the actual language in the new laws, but thoughts about just what state insurance regulators will have to do to put PPACA and HCERA into effect came up often at the NAIC’s spring meeting in Denver.

News surfaced that U.S. Health and Human Services Secretary Kathleen Sebelius, a former Kansas insurance commissioner and former NAIC president, already has hired Jay Angoff, a former Missouri insurance commissioner, to help her communicate with the NAIC and keep tabs on the private insurance market.

Kevin Lucia, a Georgetown University health policy researcher who receives NAIC funding to represent consumer interests in NAIC proceedings, tried to give members of the NAIC’s Consumer Liaison Committee an idea of the size of the task facing regulators by discussing PPACA provisions that refer directly to the NAIC.

The committee has posted Lucia’s list of those provisions on its Web site.

Some of the PPACA sections cited will do the following:

—Require the U.S. Department of Health and Human Services to consult with the NAIC to develop the summary of benefits and coverage disclosure documents required under the act.

—Create health plan external review procedures that must comply with the NAIC’s Uniform External Review Model Act.

—Require HHS officials to define permissible health insurance pricing age bands in consultation with the NAIC.

—Provide that the new health insurance exchanges must use a “uniform enrollment plan that takes into account criteria submitted by NAIC to HHS.”

—Require HHS to work with the NAIC to set the regulations needed to create the exchanges; establish qualified health plan requirements; and create risk-adjustment and reinsurance provisions and other terms of the insurance reform.

—Require NAIC to help figure out how commercial long term care insurance policies will or will not coordinate with the new CLASS Independence Benefit federal long term care benefits program.

Lucia suggests in a separate document that PPACA and HCERA indirectly will create a need for the NAIC to help with many other tasks.

“As states consider the list of legislative and regulatory tasks before them, many will seek other ‘best practice’ recommendations from NAIC, even if not required by the legislative language,” Lucia says in the document. “For example, new premium rate review standards, to be used by state and federal regulators in connection with the 2010 plan year, are an area in which the NAIC will likely need to play a larger role than the one envisioned in the federal legislation.”

NAIC will have just 6 to 9 months to give HHS officials recommendations about many PPACA and HCERA provisions, Lucia says in the document.

Also at the spring meeting, the NAIC took these actions:

—Adopted Actuarial Guideline 43-CARVM, which sets variable annuity reserving guidelines.

—Adopted a white paper on methods for helping troubled companies.

—Adopted a guideline on life and health guaranty fund disclosure notices.

In addition, the NAIC’s Internal Administration Subcommittee took these actions:

—Adopted a proposal to reinstitute salary increases for NAIC staffers effective July 1. Salaries were frozen July 1, 2009. The NAIC can increase salaries about 3.5% because its defined benefit pension plan has been doing better, officials say.

—Adopted a proposal to restructure the lines of credit that the NAIC provides for the Interstate Insurance Product Regulation Commission. The NAIC will defer principal and interest payments owed by the IIPRC until the IIPRC makes a profit of $250,000 or achieves an accumulated cash balance from operations of $500,000, officials say.

The NAIC’s Life Insurance and Annuities Committee took these actions:

—Released several valuation manual section drafts for public comment. They include sections on experience reporting requirements and reporting formats and a section on principles-based report requirements for business subject to a principle-based reserve valuation.

Also at the spring meeting, the Executive Committee of the NAIC announced it had established a Market Regulation Accreditation Task Force; a Multi-State Enforcement Task Force; and a Regulatory Modernization Task Force.

And in another development, the Accident and Health Working Group found that the 1985 NAIC cancer cost tables cannot be replaced because of a lack of data. The group is asking the American Academy of Actuaries, Washington, to help insurers and regulators cope with the deficiency by “giving “appropriate guidance on current application of the 1985 tables.”

Republican says House Dems Rejected Common Sense Reforms

Insuring Resources Commentary:

GOP Congressman Mark Kirk says House Democrats rejected several common sense Republican proposals in the debate on the House's Health Care reform bill.

He said some proposals sought to allow greater flexibility for state innovation. In not knowing the specifics I'd say state innovation should have been encouraged but the details are missing so on its face it seems like a missed opportunity to allow for some bi-partisanship.

On another issue Kirk says Dems rejected "allowing consumers to buy coverage from across state lines."

Let's analyze that one. Wisconsin insurance regulations are some of the strongest in the nation which also does add a bit of cost to our health insurance premiums. Health mandates requiring greater coverage do often add costs to health insurance premiums. BUT, we get better and more comprehensive coverage because of it. The old adage, "You get what you pay for" definitely applies here.

The wonderful state of Alabama however does not have a stellar reputation for its insurance regulations. Health insurance is cheaper there because insurers face less restrictions and mandates.

When faced with high health care premiums many businesses would seek cheaper coverage in Alabama wouldn't they, and they'd get what they paid for, wouldn't they?

What if your employer chose to purchase coverage from an Alabama-based insurer?


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Republican lawmaker says House Democrats rejected GOP proposals to improve health care bill

From JS Online 11/14/09

GOP Congressman Bashes Dems Health Care Proposals

In this week's Republican address Congressman Mark Kirk says he wants to see tort reform in health care improvements.

In this week's Republican address Congressman Mark Kirk criticizes the health care proposals pushed by Speaker of the House Nancy Pelosi.

In this week's Republican address, Congressman Mark Kirk says the Democrats' health care ideas are just too expensive.

In this week's Republican address Congressman Mark Kirk says the current health care proposals cost too much and take away too much.



WASHINGTON (AP) -- House Democrats missed opportunities to improve the House-passed health care bill when they rejected Republican ideas to limit lawsuits and give states more flexibility to enact innovative changes, a GOP lawmaker said Saturday.

Delivering the Republicans' weekly radio and Internet address, Rep. Mark Kirk of Illinois said health care costs could be lowered by "reining in lawsuits" and allowing consumers to buy coverage from across state lines. Kirk promoted several provisions in the House GOP health care bill, which was rejected a week ago when the House passed the Democratic plan.

"Unfortunately, all of these commonsense Republican reforms were rejected by Speaker (Nancy) Pelosi," Kirk said in the address. "The Pelosi health care bill has no significant lawsuit reforms and does not guarantee your medical rights from government waiting lines or restrictions."

Kirk, who is in his fifth House term representing the suburbs north of Chicago, is a candidate for the Republican nomination to run for the Senate seat that was held by President Barack Obama. He called the House Democrats' health plan "a new massive spending program, supported by heavy taxes and cuts to senior health care."

"In sum, the bill opens a new trillion-dollar entitlement just as our national debt tops $12 trillion," Kirk said.