OK-SAFE, Inc. Reporting - Meeting on Insurance Exchanges 12-8-11, Room 419-C

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OK-SAFE, Inc. Reporting – Health Insurance Exchange Meeting 12-8-11

OK-SAFE, Inc. Reporting

Meeting: Affordable Care Act Presentation*

Date: Thursday, December 08, 2011

Time: 10:00 am

Location: Oklahoma Capitol, Senate Meeting Room 419-C

Speaker: Kate Richey, of the Oklahoma Policy Institute [who apparently sponsored the meeting.]

Richey:

“ Off the record - i t doesn’t matter who establishes the exchange or governs it – it will be run

according to federal requirements.”

“ Utah is working to make their state compliant with the federal law.”

“ Those are the only two choices available now – a state-run exchange, or a partnership with

federal government.” Regarding the interim study just finished – there is one basic fact – if

Oklahoma establishes a state-run exchange, it has to be basically compliant with the feds. “ If

we do one poorly, we will end up with a federally facilitated exchange anyway.”

Summary of Kate Richey presentation/commentary on 12/8/11:

Talking points on Medicaid fraud – prevention will have to be a sustained effort.

Preventative Care Grants –for schools, providers. There are campaigns out there to emphasize

screenings that can “prevent health problems.” (OK-SAFE Comment: Screenings of non-ill

persons is a data gathering mechanism and money-maker for those offering the “service”. )

Access – Exchanges are a huge part of making sure people have access to coverage. Mix of

carrots and sticks - tax credits, subsidized premiums with a refundable tax credit, but only if they

buy their private coverage through the online exchange. Via online through the exchange will

be the only way people are going to be able to do that. Individual mandate requires that most

adults must have coverage by 2014.

Our health care blog (via website at www.okpolicy.org).

BancFirst – pay or play

Temporary high risk pool will automatically go away once the exchanges are in place. Those in

the high risk pool will be rolled over into the exchange.

http://www.oksafe.com/




Exchanges – “Goal is to lower prices. No disputing the cost data from the last 20 years. Gotta

figure out how to lower their premiums. Exchanges allow people to pool their needs.”

“You’ve got four plans and they all have to provide certain requirements – all gotta be the

same.” Could be same benefits, with different prices or same prices and different benefits.

“Easier for consumer to compare one plan with another.” Requirement for an essential benefits

plan - called a QHP – a qualified health plan.

Plan language requirement.

“It’s online, but it’s not just a website. This is a different thing. What the exchange needs to be

able to do is access both public coverage and private coverage. As life changes occur, you need

to be able to go online and make those changes.” Should be able to pay online and receive

refundable tax credit online. It will have a very sophisticated back office system.

24-hour online support to help people buy coverage.

For a state run exchange to be compliant it must be federally compliant.

Compared Utah stats to Oklahoma stats – Utah healthier. (Did not elaborate on source of stats

or mechanism for rating). Utah is working to make their state compliant with the federal law.

Question from attendee on the governance of exchange.

Richey - No opinion on which form is best. Wait until the state moves forward with legislation.

Each model has their pros and cons. “We need to take action and move forward.”

On Feb. 29, 2011 the federal government issued some answer in the form of Q & A on State

Exchanges. Is OK ready to run an exchange by Jan. 2013? The exchanges have to launch by

2014, so has to be “beta ready” by Oct. 2013.

Regarding states not being ready – “the feds are willing to meet you where you are and walk

with you through the exchange. If we turn down establishment grants, there is money still out

there. If we miss the deadlines will the funds will still be available.

Question about grants - Yes, they will be available on a rolling schedule through 2014. Check offs

1. background research – know the markets

2. How many insurers can they handle the requirements

3. Stakeholder consultation

Question - Where is the advocate in Oklahoma for the exchanges? Seems like we got derailed

by the Tea Party they just didn’t want the state to comply.

“We’re working on the governance structure.”

Not sure why the money was returned. Will have to reapply for another establishment grant

Comment from attendee - NAHU (National Association of Health Underwriters) are behind

(advocate) it. The OHCA working groups are active. We were sad to see those funds return.

The Tea Party blocked it.

There were groups there at the beginning, various advocates.

Feds will set up exchange if they need to, but they don’t want to run it for long run. Will

eventually turn it back over to the states for most of the functions. (Except data hub?)

Grant agreements come with benchmarks that must be achieved. “Even if we miss the deadlines

on these grants the money will still be available until 2014.” As far as Richey knows no one has




applied for a Level 1 or Level 2 grants. “Even if we move ahead there will be some level of

federal involvement.”

There is a tentative federal-state partnership plan being developed. There will be some sharing

of some responsibilities. Feds will regulate, run the hotlines, operate data hub. It will take more

planning, some sort of partnership model.

Those are the only two choices available now – a state-run exchanges, or a partnership with

federal government.

Regarding the Interim study just finished – there is one basic fact – if Oklahoma establishes a

state-run exchange, it has to be basically compliant with feds. If we do one poorly we will end

up with a federally facilitated exchange anyway.

Health care reform requires the electronic health records infrastructure. A group in NE

Oklahoma is working to get the state compliant with the electronic information technology

infrastructure.

OK’s High Risk Pool will be folded in to the state exchange for their coverage.

Medicare beneficiaries can get an annual wellness check without a co-pay.

End of presentation. Supposedly, the Kate Richey power point presentation will be available online via

the Oklahoma Policy Institute website – www.okpolicy.org . Click on Issues, then Healthcare.

*NOTE: This meeting about Health Insurance Exchanges under the Affordable Care Act was announced via a single

email from the legislative assistant for Speaker Pro-Tempore Jeff Hickman on 11/29/1. Apparently this meeting

was put on by the progressive Oklahoma Policy Institute. This meeting was not part of the formal Joint Legislative

Committee on Federal Health Care Reform Law meetings, which concluded on 11/15/11.

From: Ashley OlmsteadSent: Tuesday, November 29, 2011 2:34 PM

To: Legislative AssistantsSubject: Affordable Care Act presentation

There will be a presentation at 10:00 a.m. on Thursday, December 8th in Room 419C of the Oklahoma Capitol to cover Health

Insurance Exchanges under the Affordable Care Act: State-run vs. federally facilitated. This overview will include federal

requirements for a compliant state-run health insurance exchange; Oklahoma 's readiness to enact such an insurance exchange;

recent developments/predictions about legislative/executive action at the state-level on exchanges; and updates on other

federal/state health policy partnerships.

The presenter, Kate Richey of the Oklahoma Policy Institute, has a degree in International Business from the University of

Texas at San Antonio and a Masters degree in Political Science from the University of Central Oklahoma . She is currently

a PhD Candidate in Political Science from the University of Oklahoma and works as a Policy Analyst for the Oklahoma

Policy Institute specializing in health care, immigration, and anti-poverty issues.

This program can also be accessed remotely.

Ashley Olmstead Legislative Assistant to Speaker Pro Tempore Jeffrey W. Hickman Oklahoma House of Representatives Phone: 405.557.7339 Fax: 405.962.7620

OK-SAFE, Inc. Reporting - Meeting on Insurance Exchanges 12-8-11, Room 419-C

Documents

Transcript of OK-SAFE, Inc. Reporting - Meeting on Insurance Exchanges 12-8-11, Room 419-C