Entering June, Albany lawmakers scrambled to finalize a health insurance exchange that will act as an online marketplace for many buyers and sellers of insurance ”“ and which Gov. Andrew Cuomo promised will be ready in time for the 2014 implementation date specified under the federal health reform law.
Under Cuomo”™s proposal, the New York exchange could possibly include a Small Business Health Options Program, which would assist small employers in facilitating the enrollment of their employees in qualified health plans offered in the group market.
Small-business owners across the Northeast and nation are getting their first look at the rough outlines of new health insurance exchanges that will function as a one-stop shop for buying and selling insurance.
This month the Connecticut General Assembly passed a bill to create a new Connecticut Health Center Exchange, relying in part on model legislation from the National Association of Insurance Commissioners for use by specific states.
New York, Connecticut and other states have each received $1 million in funding to design their exchanges, with states also allowed to opt into a federal template created for states. Both Connecticut and New York rejected that option on a desire to craft their state exchanges to the specific designs of existing information technology systems governing Medicaid and other state programs.
Cuomo wants the New York exchange established as a public benefit corporation managed by a board of seven directors, with at least one an expert in small-business health coverage and others bringing varying expertise from the health care and insurance sector.
Cuomo also wants an advisory committee of 18 representatives of stakeholders and sectors from regions across the state that will be impacted by the operation of the exchange, including consumers, small businesses, the medical community and insurers.
The exchange must make available health plans ”“ including some dental plans ”“ to individuals and employers by Jan. 1, 2014. The exchange would establish the minimum requirements an insurer would have to meet to be considered for participation and will assign ratings to qualified health plans on the basis of relative quality and price.
States are all grappling with how to design a health insurance system to ensure that any subsidies are not so attractive that they pull in companies or individuals that might otherwise have obtained insurance in the regular market.
“We”™ve seen some problems with adverse selection in other systems that have been established and certainly we”™re learning about those,” said Jeanette Dejesus, who is leading Connecticut Gov. Darnel P. Malloy”™s efforts to marry up state systems to align with federal health reform, in testimony this spring. “We have a $1 million grant which requires us to go out in to all parts of the state to talk to small-business owners, large-business owners, people in communities and to ask them specifically what (they) believe the impact of this legislation will be. ”¦ And so the issue of adverse selection is one that will be taken up.”
