State of the States: Health Insurance Exchanges

August 10, 2012

With the dog days of summer upon us, exchange policy developments were pretty slow this week. However, Nebraska released additional details on its exchange planning and Colorado received approval from an oversight committee to submit a Level One grant application. Let’s review what else happened:

In New Jersey, five Democratic Assemblymen and two Democratic Senators reintroduced health insurance exchange legislation (A3186/S2135) last week. The bills are very similar to legislation that passed the House and Senate earlier this year only to be vetoed by Governor Chris Christie (R) on May 10. In a prepared statement, Governor Christie explained that he was vetoing the bill because he wanted to wait for the Supreme Court’s ruling on the ACA before deciding on whether to move forward with exchange implementation. Since the Court’s ruling, Governor Christie has yet to indicate if he will move forward with an exchange. During the Q&A section of a July 13 event held by the Brookings Institution, Governor Christie said he was “mak(ing) an analysis on the exchange issue” and hopes to reach “some kind of decision by the beginning of (20)13.”‪

On Thursday, the Legislative Health Benefit Exchange Implementation Review Committee officially approved Colorado’s $43 million Level One grant application. The approval follows a Legislative Health Benefit Exchange Implementation Review Committee meeting that happened the previous week on July 31. At the meeting, Exchange staff updated legislators on the IT contract recently signed with CGI, the exchange’s financial tracking and internal controls as well as community outreach plans. Legislators raised questions surrounding the long-term financial viability of the exchange and funding sources. In response, COHBE Board Chair Gretchen Hammer said that the Exchange was examining those issues but was “not to the place where we have a full financial model created."

Also this week, the Nebraska Department of Insurance updated the state’s providers and brokers on its exchange planning. Though the state lacks exchange implementation legislation, the state has been planning for a state-based exchange. Under current plans, the Nebraska Exchange will operate as a division of the Nebraska Department of Insurance. The state will develop a single exchange that services the individual and small employer markets; however, the risk pools will remain separate. Also of note, the exchange will not limit the number of QHPs.  Finally, brokers will get the “red carpet” treatment from the exchange with their own web portal designed exclusively for broker use and a separate telephone number for contacting the call center. Currently, the department is preparing an RFP to procure the exchange’s IT system.

Finally, looking to next week, we could see an announcement from HHS on grant funding for the states.  The last HHS deadline for submitting grant funding applications was June 29 and next week puts us in the final stretch of HHS’s 45-day grant approval window. Stay tuned!

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