North Carolina Gov. McCrory Opposes State Run Health Exchange

February 13, 2013Email ThisPrintNewslettersTweetArticle1 Comments

North Carolina Gov. Pat McCrory said he does not think the state is ready to run health exchanges called for in the federal Affordable Care Act.

McCrory’s office issued a statement saying the governor had reviewed the advantages and disadvantages of expanding Medicaid in North Carolina.

The state must tell federal officials by Friday if it will run the health exchanges to help those without insurance obtain coverage.

McCrory said the state is not ready to expand Medicaid and should allow the federal government to run the health exchanges.

He said the current Medicaid system is broken and not ready to expand. He said to do so would put taxpayers at risk.

He also said the federal government has not provided enough information on the long-term costs.

The Republican governor’s stance is at odds with the preference of the state’s elected insurance commissioner, Wayne Goodwin, a Democrat who supports a state-run exchange. In a recent interview with Insurance Journal, Goodwin said the decision on how the state should proceed is up to McCrory and lawmakers but Goodwin made his opinion clear:

“Just as I did with their predecessors, I have expressed my concern that the state of North Carolina knows best for North Carolinians than the United States federal government does, particularly as it relates to health insurance and exchange matters. There are a variety of reasons why the others have varying opinions, but I believe that the state should do its job and protect consumers and help regulate this marketplace.”

Goodwin told Insurance Journal he believes health care providers and the business community also prefer a state

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Florida Facing $300M Fine Over Health Insurance for Part-Time Employees

January 18, 2013Email ThisPrintNewslettersTweetArticleComments

It turns out that the state of Florida has yet another major decision to make in the next few months when it comes to the federal healthcare overhaul.

The state may be forced to make sweeping changes to its health insurance program for state workers if it wants to avoid paying substantial penalties required under the law pushed by President Barack Obama.

Officials who run the health insurance program told legislators that Florida could be on the hook for a $300 million a year penalty unless it suddenly agrees to start covering part-time employees who work at least 30 hours a week.

Florida currently doesn’t offer health care benefits to thousands of part-time employees because it’s against state law. But under the federal health care overhaul, the state in January 2014 must start covering those part-timers or risk the fine.

Barbara Crosier, director of the Division of State Group Insurance, said the latest estimates show that there are 2,200 part-timers who work at least 30 hours in state agencies and another 4,700 part-time employees working at the state’s public universities.

The cost to cover those part-time employees would be $23.5 million in the next year with the cost rising to nearly $49 million by 2015. But it’s an expense that would come at the same time that the state health insurance program is projected to be in the red. The latest estimates project the program could have a deficit of more than $260 million two years from now.

Florida overall spends $1.9 billion a year on health insurance for its employees, their families and retirees. Most of that money comes from taxpayers and not from premiums or doctor visit co-payments.

Rep. Richard Corcoran, R-Land O’ Lakes, and chairman of a House panel reviewing the federal health care overhaul, said lawmakers could pay for the part-time workers by raising premiums or changing benefits offered to full-time state workers. That’s been a contentious issue in recent years especially since state legislators and even Gov. Rick Scott currently pay relatively low premiums for health coverage.

But Corcoran said other alternatives could be to pare back the number of people who work at least 30 hours a week or create a stand-alone health insurance plan that offers different benefits from those offered to full-time state employees.

Lawmakers are expected during the 2013 session to deal with several items dealing with the federal care overhaul

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South Dakota Will Not Run its Own Health Insurance Exchange

September 28, 2012Email ThisPrintNewslettersTweetArticle1 Comments

South Dakota will not set up its own health insurance exchange, instead deferring to the federal government to operate and pay for a key component required by the federal health care overhaul, Gov. Dennis Daugaard said.

President Barack Obama’s health care law requires that each state have such an exchange, an online marketplace where patients and small businesses can shop for health insurance among competing plans. The federal government will directly operate and fund exchanges in states that choose not to operate their own.

Daugaard said South Dakota will join other states that have chosen not to run their own exchanges. About half the states apparently will let the federal government run exchanges, at least initially.

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Judge Shuts Down Christian Health Ministry Medi-Share in Kentucky

October 4, 2012Email ThisPrintNewslettersTweetArticle4 Comments

A Christians-only health care ministry must cease operations in Kentucky unless it can get regulatory approval from the state Department of Insurance, a judge ruled this week.

The ruling by Franklin County Circuit Judge Thomas Wingate means Medi-Share, a Florida-based cost-sharing ministry, can no longer accept money or help pay medical bills for churchgoers in Kentucky.

Medi-Share closely resembles secular insurance, but only allows participation by people who pledge to live Christian lives that include no smoking, drinking, using drugs or engaging in sex outside of marriage.

The case put the Department of Insurance in the unenviable position of having to fight against a Christian cost-sharing ministry in a Bible-belt state. The agency took the case to court because of concerns that some Christians might mistakenly believe they’re paying into an insurance plan that guarantees coverage if they’re hospitalized. Medi-Share offers no such guarantee.

“As a state agency, we are charged with enforcing the law and protecting consumers,” said Department of Insurance spokeswoman Ronda Sloan. “This case has continued for 10 years but it always has been about those basic principles.”

Medi-Share had continued to operate in Kentucky a year after the state Supreme Court ruled that it is subject to the same regulations as secular health care plans. Medi-Share contends that its participants aren’t buying insurance, but are involved in a charitable endeavor to help cover medical bills of fellow Christians and potentially have their own expenses covered should the need arise.

Wingate ordered Medi-Share, which is operated by Christian Care Ministry of Melbourne, Fla., “to cease all operations in Kentucky unless and until it receives a certificate of authority or other applicable license from the Department of Insurance.”

“Until that time, Medi-Share’s website must clearly state that it does not operate in Kentucky,” Wingate said in the 14-page ruling. “If the commissioner of the Department of Insurance discovers proof that Medi-Share continues to operate, the commissioner is directed to move this court for an order requiring the secretary of state to place Christian Care Ministry in bad standing.”

The legal battle between Medi-Share and Kentucky revolves around how tightly the state can regulate the Christian health care ministry that serves nearly 40,000 people in 49 states, including 800 in Kentucky. Medi-Share President Tony Meggs testified in August that the group has helped arrange for Christians across the country to pay some $25 million in medical bills for Kentucky participants over the past 10 years.

Meggs said the ministry has revamped its plan in an effort to alleviate Kentucky’s regulatory concerns by no longer collecting contributions from participants into a central account. Instead, Meggs said, participants make contributions into their own accounts at American Christian Credit Union. When Christians need money to pay medical bills, he said, money is transferred directly between member accounts, bypassing a central fund pool that was in existence at the time of the Supreme Court ruling.

Wingate refused to hold Medi-Share in contempt of court for continuing to operate, saying he found no proof that the organization acted in willful disobedience by continuing to operate after the Supreme Court ruling.

Meggs said Tuesday no decision has been made on Medi-Share will do in response to Wingate’s ruling.

“We are currently reviewing whether we will ask for a rehearing before the court or whether we will appeal the denial of our request to have the actions of the Kentucky Department of Insurance reviewed by a neutral administrative hearing officer,” he said in a statement.

Tea party activist David Adams, who has filed complaints with the Department of Insurance about Medi-Share and similar ministries, lamented the judge’s ruling but said he understands it.

“This is exactly the wrong time to be limiting health coverage choices for Kentuckians, but the way the law is written Judge Wingate had no choice,” he said.

Adams is calling on lawmakers to pass legislation exempting organizations such as Medi-Share from state regulations governing secular insurance companies so that they can continue operating in Kentucky.

 

Copyright 2012 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Email ThisPrintNewslettersTweetCategories: Southeast NewsTopics: Christians-only health plan, Kentucky Medi-ShareHave a hot lead? Email us at newsdesk

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ACLU Sues Department of Health over Restrictive Medical Marijuana Policy

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Georgia Unlikely to Run Health Insurance Exchange: Gov. Deal

November 9, 2012Email ThisPrintNewslettersTweetArticle1 Comments

A day after Barack Obama’s re-election, Gov. Nathan Deal suggested that he will not implement a Georgia health insurance exchange as part of the 2010 federal health care overhaul that ranks as the president signature legislative achievement.

Deal told The Associated Press that he wouldn’t disclose his decision until notifying federal authorities. But he noted that the state stopped planning an exchange once federal agencies wrote regulations that he says restrict Georgia’s ability to design its own program.

The decision to stop, Deal says, is “probably a pretty good indication of where we are headed.”

The law gives states the option to run the exchanges or default to the federal government. The exchanges would allow individuals to shop for private insurance.

Whether consumers would notice real differences between a federal or state exchange remains to be seen. But Deal’s reticence underscores the continued philosophical and political wrangling that surrounds implementation of the Affordable Care Act.

Congress set a Jan. 1, 2013, deadline for states to have an operable exchange. Deal has until Nov. 16 to submit an outline for an exchange or notify federal authorities that Georgia declines to open its own.

Deal said he was initially inclined to consider a state-run exchange, and in 2011, he appointed a committee that advised him on how to proceed. That panel opted against recommending a state-managed exchange.

By the time the U.S. Supreme Court ruled on the constitutionality of the law’s key provisions this spring, Deal said he would wait until after the election to make a decision. Republican challenger Mitt Romney had promised to “repeal and replace” the law, a prospect that now is moot given the president’s re-election and Democrats retaining control of the U.S. Senate.

Asked for an example of a policy that Georgia couldn’t implement as part of the exchanges, Deal cited “association plans,” a concept that would allow a professional or trade association to form a large group insurance pool

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Insurers Begin Providing Health Plan Buying Guides

September 25, 2012Email ThisPrintNewslettersTweetArticleCommentsThe Obama administration on Monday began requiring health insurers to provide user-friendly guides to patients that explain their benefits, aiming to make buying insurance nearly as easy as scanning packages of food for nutrition facts.

Under President Barack Obama’s healthcare reform law, employers and insurers must provide a summary of benefits and coverage in a clearly worded, standardized format that allows the private insurance market’s 163 million beneficiaries to make side-by-side comparisons of plan offerings.

Consumers are also required to have access to a standardized glossary of insurance and medical terms. The rule takes effect just as insurers and employers prepare for annual enrollment periods, when employees select their coverage for 2013.

The benefit guides will also factor into the creation of new state-based health insurance markets due to begin offering subsidized, private coverage to moderate-income consumers in January 2014.

The Department of Health and Human Services released an eight-page sample benefits form to demonstrate how the actual summaries will outline everything from deductibles and out-of-pocket expenses to referrals and network providers.

The guides are also supposed to show what a plan covers for two common medical situations — new births and adult diabetes.

U.S. officials compared the summaries to the Nutrition Facts label required for packaged food sold in the United States.

The rule has been criticized by the insurance industry as a new administrative burden that will increase the cost of healthcare coverage.

 

 

Copyright 2012 Reuters. Click for restrictions.Email ThisPrintNewslettersTweetCategories: National NewsTopics: buyers guide, health plan buyers guide, Patient Protection and Affordable Care ActHave a hot lead? Email us at newsdesk

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Kentucky Recommends Anthem Health Plan as Benchmark for Insurers

October 5, 2012Email ThisPrintNewslettersTweetArticleComments

Kentucky has recommended that the Anthem Preferred Provider Organization serve as the benchmark plan for insurers in Kentucky under federal health care reforms.

Anthem’s offerings would be the minimum level of benefits provided for individual and small group coverage under the Kentucky Health Benefit Exchange, an online service that will guide Kentuckians to health coverage beginning Jan. 1, 2014.

Kentucky Insurance Commissioner Sharon Clark said Anthem covers the 10 essential health benefits specified under the federal Affordable Care Act and was the most cost effective of 10 plans reviewed.

Kentucky also is recommending that the Kentucky Children’s Health Insurance Program be the benchmark plan for pediatric vision and dental services.

Both recommendations still have to be approved by the U.S. Department of Health and Human Services.

 

Copyright 2012 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Email ThisPrintNewslettersTweetCategories: Southeast NewsTopics: Anthem, employee benefits, health exchange, Kentucky health exchange, minimum benefitsHave a hot lead? Email us at newsdesk

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Vanessa-Care: Health Coverage Without Lifetime Limits

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New Report: Health Care Law Saves Money for Consumers

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Connecticut Moving Ahead With New Health Care Exchange

August 28, 2012Email ThisPrintNewslettersTweetArticleComments

Connecticut officials are pushing ahead with plans to set up the new health insurance exchange, a marketplace where individuals and businesses can find affordable coverage, by next fall.

The federal Center for Medicare and Medicaid Services last week awarded the state a $107 million grant. It was the latest allotment from the federal government as part of President Barack Obama’s health care overhaul law. To date, the state has now received a total of $116 million.

Connecticut is one of a handful of states to have received a so-called Level-Two Establishment Grant. It joins Washington, Rhode Island, Maryland, Nevada and Vermont.

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Consumers Uninformed About Health Care Reform

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Insurers, Providers Brace For Health Care Decision

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Virginia-Care: Keeping Health Insurance Costs Down for a Small Businesses

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Annie-Care: Providing Preventive Services to Patients in Community Health Centers

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Collecting the Data We Need to Reduce Health Disparities

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The State of Latino Health Twitter Chat

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