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January 2012 St@teside

Exchange Roundup

Exchange Leadership

On December 7, the Legislative Implementation Review Committee, a committee of state legislators that oversees the Colorado Health Benefits Exchange voted unanimously to approve Patty Fontneau as the exchanges’s executive director and chief executive officer.  Previously, Ms. Fontneau was the chief operating officer of Holme, Roberts & Owen LLP.  She serves on the boards of CollegeInvest, the Auraria Foundation, the Downtown Denver Partnership and other organizations. Ms. Fontneau started her new position on December 12.

On December 15, the Committee also approved the submission of the Colorado Health Benefit Exchange's Level One Establishment Grant application. The application requested almost $18 million to continue analyzing the insurance market, working with stakeholders, developing an information technology system for the exchange, and creating an appeals process.

On December 30, Nevada’s Health Insurance Exchange board named Jon Hager as its executive director for the exchange.  He is currently the chief financial officer for the Public Employee Benefits Program.

State-Based Exchanges or Not?

Georgia’s Health Insurance Exchange Advisory Committee recently issued its final report recommending that the state set up a small business exchange outside of the PPACA-prescribed SHOP Exchange requirements. The committee did not endorse the establishment of an exchange for the individual market. The report also recommends that the exchange be run by either a private or quasi-governmental entity and stresses the need for the state to set up an exchange in order to maintain its authority over the insurance market rather than cede that power to the federal government.  It also emphasizes that the options for the exchange would be studied independent of the requirements of health reform law.

Pennsylvania’s Governor Tom Corbett made a decision on November 22 to develop a state-based health insurance exchange for small businesses and individuals. The decision was, in part, supported by the analysis in a KPMG report prepared for the Pennsylvania Department of Insurance estimating that 2.1 million people would participate in an exchange in 2014. The report explores the advantages and disadvantages of establishing a state-based exchange compared to participating in a federally-facilitated exchange, and also provides options for the structure of the exchange. According to the Department of Insurance, the next steps for Pennsylvania are to establish legislation and apply for a federal grant.

South Carolina’s Health Planning Committee issued a report in November recommending against the implementation of a state-based exchange. According to the report, establishing a state-run exchange is not desirable since there is no clear federal guidance on how to implement a state-based exchange. Furthermore, the report raises concerns with the proposed rules regarding the role of navigators as well as the uncertainties about the legal challenges to the health care law. The committee recommended that the state encourage and facilitate the establishment and expansion of private exchanges. The report also emphasizes the need for the state to “maintain control over all aspects of health care funding and provision including control over any marketplace reforms.”