The Affordable Care Act had a full outing today in Washington.
Forty-four states are participating in the premium rate review system system and 28 states and the District of Columbia are on their way to establishing their own health insurance exchange, both major tenets of the health care reform act singed two years ago. The Obama Administration trumpeted the news today in a report a week before President Obama's final State if the Union this term, as House Republicans tried to kill the long term care element of the Act once and for all.
The health care exchanges are to be up and running in 2014 to offer to the public the same kinds of insurance choices members of Congress have. States have the authority to set the, up and run them through grant programs.
Three rounds of establishment grants have been awarded. In addition to the 28 states on their way, additional states applied for exchange establishment grants in December, with awards to be made in February.
Rhode Island was the first state to receive a level two grant, which provides multi-year funding to states further along. The Department of Health and Human Services had announced a six-month extension for level one establishment grant applications, to June 29, 2012, from Dec. 30, 2011, and outlined in guidance further modifications, future guidance and new tweaks on various other exchange deadlines and parameters.
The White House used testimonials from Democratic and Republican governors and state legislators in 10 states to provide a positive snapshot of progress.
Mississippi Commissioner of Insurance Mike Chaney was quoted in the White House report as saying last spring, for example, that a healthcare exchange is not a partisan political issue.
"Across this nation, Republicans and Democrats alike have embraced the concept of health exchanges as a way to help individuals and small businesses more easily obtain health insurance," Chaney stated.
Some have noted small businesses would welcome an exchange when given all the facts.
Still, health exchanges are snubbed in some states like Florida, Wisconsin and South Carolina, while the Act itself is itself challenged by 11 states. Many other aspects of the reform bill, such as the CLASS program and medical loss ratio requirements remain contentious, requiring regulators, legislators and the industry to scramble to adopt to the new health care regime as it takes hold over a period of time between now and 2014.
The U.S. Supreme Court is considering the constitutionality of PPACA. If the act survives, the exchanges are supposed to start distributing coverage Jan. 1, 2014.
While the White House announced its health care exchange advances, however, a markup proceeded in the House Ways and Means Committee to vote to repeal the PPACA's floundering CLASS program commenced, under the stewardship of Republican leadership.
The "Fiscal Responsibility and Retirement Security Act of 2011," or H.R. 1173, was written expressly to repeal the Community Living Assistance Services and Supports (CLASS) long-term care insurance program provisions that were part of PPACA. The CLASS program has been considered stillborn since HHS Secretary Kathleen Sebelius appeared to stop work on it in October, when the HHS itself questioned the program's projected costs and sustainability. However, legislators maintain that the CLASS law needs to be repealed before long-term care can be addressed properly.
