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WASHINGTON In a major surprise on the politically charged new health care law, the Obama administration said Friday that it would not define a single uniform set of "essential health benefits" that must be provided by insurers for tens of millions of Americans. Instead, it will allow each state to specify the benefits within broad categories.
The move would allow significant variations in benefits from state to state, much like the current differences in state Medicaid programs and the Childrens Health Insurance Program.
By giving states the discretion to specify essential benefits, the Obama administration sought to deflect one of the most powerful arguments made by Republican critics of President Obamas health care overhaul that it was imposing a rigid, bureaucrat-controlled health system on Americans and threatening the quality of care. Opponents say that the federal government is forcing a one-size-fits-all standard for health insurance and usurping state authority to regulate the industry.
Friday, 02 December 2011 - The State of Utah is gaining ground pushing back against the federal government on the Affordable Care Act. A FAQ-style memo from the U.S. Department of Health and Human Services (HHS) this week signals new policy positions which allow states significant flexibility to implement exchanges that reflect state practices, preferences, and market goals.
"It's a good start in the right direction. Long before the new federal health care bill passed, our Exchange was built around the needs of consumers and small business, with minimal government involvement and expense," said Governor Gary R. Herbert. "We've worked for many months to make sure the federal government would not smother our exchange, but we've been at an impasse. However, this new flexibility allows Utah's Exchange to continue in its current market-based design."
"The best solutions come from the states, each with a different market and unique circumstances. We are encouraged that Secretary Sebelius recognizes the critical role of the States and the value of not forcing a one-size-fits-all solution on us," said Lt. Governor Greg Bell. "When I saw HHS's proposed rules this summer, I was worried that all of our hard work would be wasted. But this announcement gives me hope that we can continue to develop a Utah solution to Utah problems, and the federal government may actually support that instead of trying to take it over."
November 8, 2011 - The CMS on Tuesday granted the state of Georgia some leeway in implementing the healthcare reform law's medical-loss-ratio standard for 2011 through 2013.
Georgia's Insurance Department had requested an adjustment of the medical-loss-ratio standardwhich requires insurance companies to spend at least 80% of premium dollars on medical expensesso that companies in the state would be permitted instead to spend 65% on premiums in 2011, 70% in 2012, and 75% in 2015. In its decision, the CMS determined that applying the full 80% standard in 2011 may lead to destabilization of the individual market in Georgia, but not to the degree that would warrant the standards that the state insurance department requested.
Consequently, we have determined that the MLR standard in Georgia shall be adjusted to 70% in 2011 and 75% in 2012, with the statutory standard of 80% to apply beginning in 2013, Steven Larsen, deputy administrator and director of the CMS' Center for Consumer Information and Insurance Oversight (CCIIO), wrote in a 14-page letter to Ralph Hudgens (PDF), Georgia's insurance commissioner.
Monday, December 12, 2011 - The federal government on Monday granted Texas a waiver that could mean billions more in Medicaid dollars to hospitals over the next few years in return for having them work together to provide better care for the poor.
"This waiver will allow us to replace an archaic federal Medicaid funding system with one built around local solutions that reward hospitals for patient care and innovation," said Tom Suehs, executive commissioner of Texas Health and Human Services.
Sep 19, 2011 - Worried that the federal government could end up running new insurance marketplaces for dozens of states, the Obama administration is making a new pitch for cooperation to 46 states and the District of Columbia today. [...]
Planning for exchanges is something the Obama administration is working to encourage. "The notion of having many state exchanges completely federally run may not be appealing to the administration," said Linda Blumberg, senior fellow at the Urban Institutes Health Policy Center. "The feds have been trying to be more aggressive about discussing partnership options with the states. They are looking for mechanisms for more flexibility to give states a hand in it without this being overwhelming to the states."
The partnership model helps states decide which functions they are ready to perform and which they would like to leave to the federal government, and for how long, said Steve Larsen, director of the Center for Consumer Information and Insurance Oversight at Health and Human Services. "This model allows HHS and the states to be as logical and efficient with our resources as possible, while giving states the opportunity to perform the functions most important to tailoring an exchange to the unique needs of their state."
