Supreme Court to Rule on Health Reform Law
The Supreme Court has decided it will rule on the constitutionality of the health reform law. The Court will hear the longest oral argument in modern Court history. During the 4-1/2 to 5-1/2 oral argument, the Court’s grant of certiorari will address three issues: (1) Are the challenges to the individual mandate prohibited by the Anti-Injunction Act? (2) Did Congress exceed the scope of its constitutional authority by passing the health reform law? (3) If one part of the statute is unconstitutional, does that mean the entire statute should be invalidated? Oral argument is expected to occur in March 2012, with a decision to come by the end of June 2012.
COBRA Subsidies Update
The American Recovery and Reinvestment Act of 2009, initially signed on Tuesday, Feb. 17, 2009, provided a 65 percent federal subsidy of COBRA premiums from Sept. 1, 2008, to Dec. 31, 2009, for involuntarily terminated employees, subject to certain income limits. The last extension of eligibility for the COBRA subsidy ended on May 31, 2010, and the maximum period for COBRA subsidies is 15 months. Therefore, August 31, 2011, marked the end of COBRA subsidies in most cases.
If you have lost your COBRA subsidies, check around with various healthcare insurers. For instance, Blue KC has many affordable direct pay plan options available. If interested, visit www.BlueKC.com.
August Update
There has been a lot of activity during the past few months with several new health care reform regulations being published. The below will provide a general overview of each regulatory update.
Rate Review
On May 23, 2011, the final rule for the Department of Health and Human Services and States to establish a process for the annual review of unreasonable premium increases for health insurance coverage was published in the Federal Register. The rate review program is designed to ensure that all rate increases that meet or exceed an established threshold (10 percent) are reviewed by the appropriate state or Centers for Medicare & Medicaid Services to determine if the rate increases are unreasonable.
New Rule on Health Insurance Exchanges
Long-awaited guidance around a key element of health care reform was released on Monday, July 11. The Department of Health and Human Services issued a series of proposed regulations under health care reform including how states can establish exchanges to buy insurance.
Missouri Senate Interim Committee Evaluates Exchanges
The Missouri Senate has formed the Senate Interim Committee on Health Insurance Exchanges to evaluate if Missouri should begin building a state based health insurance exchange.
Updates on the Temporary High-Risk Pool Program
Health and Human Services (HHS) recently announced several changes to the Pre-Existing Condition Insurance Plan (PCIP) temporary high-risk pool program. The high-risk pool program was formed as part of health care reform legislation to help provide affordable health insurance coverage to people who are uninsured due to pre-existing conditions.
States can choose to participate in the program which is funded entirely by the Federal government and will end on January 1, 2014, when health insurance exchanges are formed.
Next Steps for Missouri Health Insurance Exchange
At the end of its legislative session, Missouri advanced its State-based Exchange bill through the House; however, the bill encountered opposition in the Senate. Agreement was reached that an interim Senate Committee will be formed this summer for a committee to work on a Missouri Exchange bill that would be acceptable. There will be a Senate bill and a companion House bill with a strategy to expedite the process and hope to have the bill on the Governor’s desk by early March 2012.
The Exchanges are a result of the Federal Patient Protection and Affordable Care Act that mandates everyone have health insurance by 2014. They would provide, at the state level, an online marketplace for individuals and small groups to purchase health insurance.
If legislation is not passed for Missouri to operate its own State-based Exchange, the alternative will be to have an Exchange that is run and overseen at the federal level. Proponents of a State-based Exchange want to keep the oversight on a “local” level and predict that a federally-operated Exchange would eliminate the ability to meet the needs of Missourians. Keeping the control at a State level would allow Missouri representatives, who have a closer connection with Missouri residents, to create the best Exchange for them.
New Regulations and Guidance on 10 Topics
Blue Cross and Blue Shield of Kansas City legal representatives attended the Blue Cross and Blue Shield Association Legal Department Cooperative Health Care Reform Roundtable with regulators in Washington, D.C. recently. The regulators updated the group on upcoming regulations, stating that new regulations and guidance will be issued on 10 topics between now and the end of the year. The topics include transparency, exchanges, risk adjustment, essential health benefits, insurance reforms, rate review, Medical Loss Ratio, appeals, standard coverage summaries, and quality reporting. It is anticipated that some of the regulations will be burdensome and at least one regulation will be more than 1,000 pages.
State Health Insurance Exchanges – State or Federally-Run?
Statewide Health Exchanges, which will enter the market on Jan. 1, 2014, provide the broadest change under health care reform. Individual and small group consumers will be able to purchase health insurance online through an “exchange market.”
CLASS Act Education Now Offered
The Community Living Assistance Services and Support Act (CLASS) addresses the issue of long-term care and is part of the Patient Protection and Affordable Care Act.