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.
