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Health Care Reform
Federal Legislation
In March 2010, Congress and the President enacted two bills: the Patient Protection and Affordable Care Act (PPACA), and the Health Care and Education Reconciliation Act of 2010. While some reform elements are already in effect, the majority of changes will be phased-in over time, concluding with the opening of state health insurance exchanges for individuals and small business in 2014. Once operational, state exchanges will provide venues for qualifying individuals to "shop" for quality, comprehensive health insurance plans at competitive rates.
State Health Care Exchanges: Impact to CRCs
Individual state health care reform councils are currently evaluating and determining which services and corresponding service providers should be covered by insurers certified to offer their products on their state's exchange. During this critical stage, CRCC is proactively advocating for the inclusion of rehabilitation counseling for individuals with disabilities, with CRCs being the professionals qualified to provide those services. This is a critical time for CRC voices to be heard. If you are a CRC, please consider volunteering your time, in any amount. Experience working with legislators is not needed; CRCC will provide information, guidance, and support for all volunteers. To volunteer, go to CRCC Health Care Reform Volunteer Questionnaire.
In July 2011, the United States Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking setting guidelines for the creation of State Health Benefit Exchanges and a process for federal approval of those exchanges. The Proposed Rules allow for states to organize the governance of their exchange as an independent public entity, a separate state agency, or as part of an existing state agency.
Active State Discussions and Policy Groups
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Alabama
Alabama Department of Insurance Stakeholder Meetings
April 2011
The Department of Insurance is holding meetings regarding health care reform implementation in the state. The meetings are chaired by the Insurance Commissioner, Jim Ridling or a member of his staff. The meetings are focused around generating input from stakeholders in four areas of exchange implementation: 1) Enrollment and Consumer Assistance; 2) Exchange Administration; 3) Qualified Health Plan Administration; and 4) IT and Technology Requirements. The Department of Insurance will utilize the information from stakeholders in its design and implementation of the exchange. The group held meetings in December and January - the date of the next meeting has not been announced.
Alaska
Alaska Health Care Commission
September 2011
The Alaskan Health Care Commission is chaired by Dr. Ward Hurlburt, Chief Medical Officer for the Alaska Department of Health & Social Services. The Commission's 11 voting members include hospital directors and administrators, health insurance executives, non-profit leaders, doctors, community health center directors, health care providers, and other individuals with expertise in Native American, veteran, and family health issues. The Commission also has three non-voting members: Linda Hall, Director, Division of Insurance, Alaskan Department of Commerce, Community and Economic Development; Representative Wes Keller (R); and Senator Donald Olson (D).The Commission will receive briefings on Health & Health Care in Alaska and federal health care reform and the status of impact analyses and implementation activities in Alaska. The Commission will also identify their interests and concerns regarding health care in Alaska and determine goals for a 2010 Commission Report to the Governor and Legislature by 1) Identifying gaps in knowledge about Alaska's health care system; 2) Identifying highest priority system transformation strategies; and 3) Identifying measures for tracking progress of Alaska's health care system.
At its recent meetings, the Commission has discussed various topics including health care spending, health information infrastructure initiatives, and health information technology. The Commission met on August 25th and 26th, and is scheduled to meet again on October 11th and 12th.
Arizona
Check back for future activity updates.Arkansas
Health Benefits Exchange Planning Division Steering Committee and Workgroup Meetings
September 2011
The Health Benefits Planning Division is contained within the Department of Insurance. The Division was created through a grant provided by the Office of Consumer Information and Insurance Oversight and the U.S. Department of Health and Human Services. The purpose of the Division is to plan and implement a health benefit exchange in accordance with the Patient Protection and Affordable Care Act. A Steering Committee and six workgroups have been established to assist with planning and implementation. The workgroups are focused in the following areas: (1) Consumers; (2) Information Technology; (3) Community leaders; (4) Outreach/Education/Enrollment; (5) State Agencies; and (6) Providers.The Department of Insurance received a $1 million exchange planning grant from the Department of Health and Human Services and has used this grant to establish the Health Benefits Exchange Planning Division (Division). The Division, with Cynthia Crone as the Director, established a Steering Committee and work groups to assist with planning and implementation of a health insurance exchange. The Division will hold a Stakeholder Exchange Planning Summit on October 11th.
California
California Health Benefit Exchange Governing Board
September 2011
The Health Benefit Governing Board was established by legislation in 2010 and became effective January 1st, 2011. The Board members are all appointees. Two were appointed by Governor Schwarzenegger - Susan Kennedy, his former chief of staff, and Kim Belshé, the former Secretary of Health and Human Services. By statue, the third member is the current head of Health and Human Services, Diana Dooley. The Assembly Speaker named Paul Fearer as the Fourth member of the Board. The Senate President has appointed the final member of the Board, Robert Ross, M.D. The Board has had several initial meetings which covered primarily organizational issues, including building a staff and submitting grant applications. The Board held meetings on August 23rd and September 27th to discuss a strategic vision on the formation and implementation of the Exchange. The next meeting will be held on October 21st. Materials and reports from the September meeting are available online. View CA Materials
Colorado
Colorado Health Reform Implementation Board
September 2011
The Interagency Health Reform Implementation Board was established by Governor Bill Ritter's executive order in 2010 to provide the governance, rules, and administrative infrastructure to facilitate planning and implementation of health care reform in the state. The Board held a series of community forums to collect input from stakeholders and consumers regarding health care reform implementation. Subject-specific task groups are formed as needed for advisory purposes. The next meeting is scheduled for November 14th.
Colorado Health Insurance Exchange Board
September 2011
In May 2011, the Colorado General Assembly adopted Senate Bill 11-200, creating a process for implementation of a Health Benefit Exchange in Colorado as an independent public entity not affiliated with an existing state agency or department. The bill also established a Board of Directors to govern the Exchange made up of members appointed by both the Governor and the Legislature. During its initial meetings, the Board focused on administrative measures, with a shifting focus on strategic Exchange matters. Beginning October 10th, 2011, the Board will meet the second and fourth Monday of each month.
Connecticut
Connecticut Governor's Health Care Reform Cabinet
September 2011
The Governor's Health Care Reform Cabinet, chaired by the Deputy Commissioner of the Department of Public Health, was created by the Governor in Executive Order 43. The Cabinet is charged with developing a strategy that applies national health care reform building upon Connecticut's successful health care programs to ensure that Connecticut's residents and businesses realize the benefits of national health care reform. It will also pursue federal funding and/or foundation funding opportunities to assist in developing the exchange and implementing any other aspects of health care reform.
Connecticut State-Wide Primary Care Access Authority (SPCAA)
September 2011
The SPCAA was established by, and reports to the Legislature, but membership consists of other state health care leaders. Current co-chairs of the SPCAA are Margaret Flinter of Community Health Center, Inc., and Tom Swan of Connecticut Citizen Action Group (CCAG). The Authority discussed health reform and has reviewed progress reports on the implementation of the Patient Protection and Affordable Care Act. The last meeting of the SPCAA was held in July.
Connecticut Health Insurance Exchange Planning Grant Committee
September 2011
The Connecticut Health insurance Exchange Planning Grant Committee is working to implement and design the Exchange. The State was awarded a $1 million Planning and Implementation Grant in September 2010. The Committee is using the grant funds to gather input and resources on the design and implementation of the Exchange. The Committee held several public forums throughout the State on Exchange development. The Committee continues to meet to consider additional grants and future stakeholder involvement in the development of the Exchange. The next Committee meeting has not been announced. Connecticut Health Insurance Exchange Board
September 2011
The Connecticut Health Insurance Exchange Board of Directors (Board) will oversee the development and implementation of the Connecticut Health Insurance Exchange, a quasi-public authority. Both the Exchange and the Board are mandated by federal law and created pursuant to state legislation, Public Act No. 11-53 (referenced at CT18125). The Board will be composed of 14 members. Eleven Board members will have voting rights, including three from the Executive Branch. The Executive Branch members will be: 1) Jeannette DeJesus, the Special Advisor to the Governor on Health Reform; 2) Commissioner Roderick Bremby from the Department of Social Services; and 3) Secretary Benjamin Barnes from the Office of Policy Management. The Governor will appoint two members of the Board, and legislative leaders will appoint the remaining six. The Governor will name a Chairperson for the Exchange. There are also three ex-officio non-voting members: Vickie Veltrie as the Healthcare Advocate, Commissioner Jewel Mullen of the Department of Public Health, and Commissioner Thomas Leonardi of the Connecticut Insurance Department. The Board will meet on a monthly basis - its first meeting was on September 15th.Connecticut Office of Health Reform and Innovation
September 2011
The Office of Health Reform and Innovation was established to coordinate the work of the State around health reform implementation. Located in the State Capitol Building, it will have one staff member and, in consultation with the Governor’s Cabinet, will convene a consumer advisory board that consists of at least seven members. The State is also a member of the consortium of New England states awarded a federal "Early Innovator" grant to help with the design and implementation of the information technology infrastructure needed to operate a health insurance exchange. In addition, the Office of Health Reform and Innovation will convene a working group to develop a plan to implement a statewide multi-payer data initiative to enhance the state's use of health care data from multiple sources. The goals of the initiative are to increase efficiency, enhance outcomes, and improve the understanding of health care expenditures in the public and private sectors.Delaware
Check back for future activity updates.District of Columbia
District of Columbia Health Reform Implementation Committee
September 2011
Established by Mayor's Order in 2010, the Health Reform Implementation Committee oversees the implementation and coordination of health care reform. The four cabinet members are Commissioner Gennet Percell (co-chair) of the Department of Insurance, Securities, and Banking, Dr. Julie Hudman (co-chair) of the Department of Health Care Finance, Dr. Pierre Vigilance of the Department of Health, and Clarence Carter of the Department of Human Services. The Committee began meeting in May 2011. At its initial meetings, The Committee discussed the goals of the Exchange and governance of the Exchange, as well as facilitating stakeholder input. The next Committee meeting has not been announced.
The Committee created five sub-committees to review various issues pertaining to the implementation of health care reform: 1) Health Insurance Exchange Sub-Committee; 2) Consumer Outreach Sub-Committee; 3) Delivery System Reform Sub-Committee; 4) Insurance Regulations Sub-Committee; and 5) Medicaid Expansions Sub-Committee. There are no sub-committee meetings scheduled at this time.
The Health Insurance Exchange Sub-Committee will conduct analysis of how the District's Exchange could be structured to best achieve expanded health insurance access, education, information and affordability.
The Consumer Outreach Sub-Committee is responsible for providing information about how reform will affect various stakeholders and how they might participate in the implementation process.
The Delivery System Reform Sub-Committee will coordinate the opportunities for pilots, demonstration projects, and other mechanisms to test and evaluate delivery system changes designed to improve quality and control costs. The Sub-Committee will work to identify new opportunities and maintain focus on delivery system changes that result in improved health outcomes and reduced costs.
The Insurance Regulations Sub-Committee is responsible for researching and providing guidance to the Committee on legislative, regulatory, and policy changes to implement health reform.
The Medicaid Expansions Sub-Committee is tasked with developing and implementing the Medicaid expansion that was included within health care reform.
Florida
Check back for future activity updates.Georgia
Georgia Exchange Advisory Committee
September 2011
The Exchange Advisory Committee, led by the Governor's Office and is comprised of various stakeholder groups, is a working group to assess the feasibility of establishing a state run health benefit exchange. The Committee is comprised of a diverse group of stakeholders, including healthcare providers. In addition to its meetings, the Committee held several stakeholder meetings throughout the state to receive input from the public - the final Committee meeting will be on October 25th. The Committee is then scheduled to submit a report to the Governor on December 15th. No stakeholder meetings are scheduled.
Hawaii
Check back for future activity updates.Idaho
Idaho Health Care Task Force
September 2011
The legislature's Health Care Task Force has been meeting to hear testimony on various aspects of federal health care reform. Specifically, the Task Force has heard from the Idaho Department of Insurance, the Department of Health and Welfare, and the High Risk Insurance Pool Board on the impact of federal health care reform on department specific activities. The Task Force has also heard from Blue Cross Blue Shield on health care reform's impact on products, rates and policies. The Office of the Attorney General has spoken to the Task Force on the status of Idaho's lawsuit on federally mandated health insurance. The Task Force, co-chaired by Senator Dean Cameron (R) and Representative Gary Collins (R), last met in January 2011. The 2011 legislative session adjourned without the introduction of Exchange legislation. The Task Force has no future meetings scheduled.
Illinois
Illinois Health Care Reform Implementation Council
September 2011
The Health Care Reform Implementation Council was formed by Executive Order in 2010 to implement health care reform in Illinois. The Council was charged with making recommendations to assist the state in establishing a health insurance exchange and other consumer protection reforms; reform Medicaid; and foster the widespread adoption of electronic medical records. The Council submitted its first report March 1st, 2011 which included several recommendations on the exchange implementation and Medicaid expansion. The Council has not scheduled additional meetings and has no timeframe for its next report. Illinois Department of Insurance Exchange Working Groups
September 2011
The Department of Insurance established four working groups to involve similarly situated stakeholders in various aspects of the exchange. The working groups each held one meeting in Winter 2010-2011. No additional meetings were held and none are currently scheduled.
The Long-Term Sustainability Working Group is looking at ways to ensure the exchange is developed to ensure its long term success and has received the perspective of patient and family advocates, producers, employers, insurers, and providers.
The Exchange Operating Model Working Group is considering different models of how to structure the exchange and has received the perspective of patient and family advocates, producers, employers, insurers, and providers.
The Exchange Enabling Legislation Working Group is developing the legislation which will ultimately be introduced in the Illinois Legislature to establish the state exchange.
Indiana
Indiana Health Finance Commission
September 2011
Comprised exclusively of members of the Indiana Legislature, the Commission held its first meeting to discuss Exchange implementation on July 13th, 2011. It heard reports on the types of Exchange that is being considered for implementation in Indiana, as well as the plans to include stakeholders in the implementation process. The Commission last met on September 28th. Indiana Select Joint Commission on Medicaid Oversight
September 2011
Governor Mitch Daniels (R) issued an executive order authorizing the Family and Social Services Administration to work with the Department of Insurance and other state agencies to conditionally establish and operate a state-based health insurance exchange as part of the implementation of the Patient Protection and Affordable Care Act (PPACA). An interagency task force comprised of members of the Governor's Office, the Family and Social Services Administration, and the Department of Insurance has been formed to discuss the various components of the PPACA. The Commission met on August 23rd to receive an overview of the development of healthcare reform and exchange planning.Iowa
Iowa Health Benefit Exchange Interagency Working Group
September 2011
A Working Group has been formed between the Department of Public Health, Department of Human Services, Insurance Division, and Department of Revenue to organize the initial planning of the Iowa Health Benefit Exchange. The Working Group has conducted focus groups for consumers and businesses, held regional meetings, and will be creating a new advisory council to lead the implementation of the exchange. The Working Group held meetings in December 2010 and January 2011 - no additional meetings have been scheduled.
Kansas
Kansas Department of Insurance Stakeholder Group
September 2011
The Department of Insurance has created a stakeholder group to assist in planning for the establishment of the health insurance exchange. The Department held its first meeting in January 2011 with stakeholders given the opportunity to join one of eight work groups: 1) Focus/Business Operations Issues; 2) Governance/Legal/Legislative; 3) Background Research; 4) Consumer Outreach/Education/Information; 5) Inside/Outside the Exchange (regarding whether plans should be sold outside the exchange, and if so, how to regulate the market); 6) Funding/Financial; 7) Agents/Brokers/Navigators; and 8) Medicaid Integrations. The work groups have continued to meet to discuss their respective areas of Exchange implementation.
The Committee Chairs and Steering Committee meetings scheduled for September 21st were canceled to allow committee members to meet with federal officials in Washington, D.C. and have been rescheduled for October 20th. The Training Subgroup of the Agents/Brokers/Navigators Work Group met on September 23rd. The Governance/Legal/Legislative Group will meet on October 4th. The Agents/Brokers/Navigators Full Work Group will meet on October 19th. The Medicaid Integration and Interagency Communications Work Group will meet on October 26th.
Kentucky
Check back for future activity updates.Louisiana
Louisiana Health Care Commission
September 2011
The Commission, created within the Department of Insurance, is responsible for reviewing and studying the availability of health care in Louisiana. It is tasked with the review of issues pertaining to the implementation of the PPACA, including Exchange implementation. The Commission last met on August 26th. Governor Jindal has indicated, at present, that Louisiana will not create a state exchange.Maine
Maine Health Reform Implementation Steering Committee
April 2011
The Committee was created by Executive Order and established the permanent membership to include the Director of the Governor's Office of Health Policy and Finance, the Commissioner of the Department of Health and Human Services, the Commissioner of the Department of Professional and Financial Regulation, the Superintendent of Insurance and the Executive Director of the Dirigo Health Agency. The Committee heard presentations from the Advisory Council on Health Systems Development (ACHSD), the Joint Select Committee on Health Care Reform Opportunities and Implementation, and the National Academy of State Health Policy (NASHP), as well as the Federal Health Care Reform Options for MaineCare and CHIP. In addition it has been working with the National Governor's association and Federal officials to discuss how Dirigo will need to be altered for the PPACA. The Committee released its final report in December 2010.
Maryland
Maryland Health Care Reform Coordinating Council
September 2011
September 2011
Created by Governor O'Malley through Executive Order, the Maryland Health Care Reform Coordinating Council is to consider and analyze the policy choices and implementation decisions necessary in the implementation of the PPACA. The Council will make recommendations to the Governor on how best to improve quality and reduce costs. After submitting its final report to Governor O'Malley in January 2011, the Council has continued to meet and consider policies for PPACA implementation. The date of the next Council meeting has not been set.
Six working groups open to the public were created by the Council: 1) Health Insurance Exchange and Insurance Markets; 2) Entry to Coverage; 3) Outreach and Education; 4) Public Health, Safety Net, and Special Populations; 5) Health Care Workforce; and 6) Health Care Delivery System.
The Health Care Workforce Group focused on considering and finding strategies to prepare health care workers for the future when the new federal law becomes effective. Currently there is a shortage of health care workers in Maryland and with the increase in the accessibility of health care, this issue warrants further study. In 2010, the Workgroup met three times between September and October 2010 and submitted a report to the Council on October 31st.
Massachusetts
Massachusetts Stakeholder Meetings
September 2011
The group of agencies tasked with implementing health care reform in Massachusetts holds quarterly meetings, open to the public, where any stakeholder or general public member can attend and comment. A stakeholder meeting was held on June 21st - the next meeting has not been announced.
Michigan
Check back for future activity updates.Minnesota
Minnesota Health Care Access Commission - Health Insurance Exchange Working Group
September 2011
The Minnesota Health Insurance Exchange Working Group is comprised of state legislators and members of the public. Senator Linda Berglin (DFL) and Representative (DFL) Paul Thissen chair the meetings. The Working Group has reviewed the functions of the health exchange, while listing potential additional functions to consider pertaining to other requirements of federal law and identifying similar functions currently being performed by state agencies/other organizations. Furthermore, the group has reviewed market rules and plan participation requirements, the risk pooling and adverse selection issues, provisions in the PPACA that mitigate adverse selection issues, and current Minnesota law affecting adverse selection including "qualified health plan" requirements. The next meeting of the Working Group has not been established.
Mississippi
Check back for future activity updates.Missouri
Check back for future activity updates.Montana
Montana Exchange Stakeholder Involvement Council
September 2011
The Securities and Insurance Commission (Commission) established the Exchange Stakeholder Involvement Council (Council) to receive input and recommendations from stakeholders regarding exchange implementation. Chaired by Commissioner Monica Lindeen, the focus of the Council meetings is to review and comment on the Commission's draft of HB 124, which establishes the exchange in Montana. Input and recommendations from stakeholders are being used by legislators to review and make additional changes to HB 124. The Council met on April 7th in Helena. The date of the next meeting has not been established.
Montana Exchange Interagency Work Group
September 2011
The Securities and Insurance Commission established an Exchange Interagency Work Group to coordinate the construction and implementation of the health insurance exchange across state agencies. The Work Group is chaired by Monica Lindeen, Securities and Insurance Commissioner. Representatives from the Governor's Office, Legislative Services Division, Department of Administration, Department of Public Health & Human Services, and Indian Health Services are all participating. The Work Group reviewed and made comments on the Commission's draft of HB 124, the bill introduced in the Legislature to construct and implement the exchange. It has also discussed high level coordination of implementation between various agencies. While the Work Group has continued to meet to discuss basics of Exchange implementation, the next meeting has not been announced.
Montana Economic Affairs Interim Committee
September 2011
The Economic Affairs Interim Committee is studying the feasibility of creating a state-based health insurance exchange or participating in a regional health insurance exchange. The Committee met on August 23rd and 24th. Marguerite Salazar, a regional director with the U.S. Department of Health and Human Services, told the Economic Affairs Interim Committee that the U.S. Department of Health and Human Services is working on a partnership model for an exchange. Nebraska
Nebraska LR 467 Select Committee
April 2011
The legislative Select Committee was created by LR 467, authored and chaired by Senator Tim Gay (I). The Committee is to study: 1) the effect of the federal Patient Protection and Affordable Care Act on Nebraska; (2) the role of employer-sponsored insurance and public programs in providing health care coverage for Nebraskans; and (3) available funding options to ensure a financially sustainable and affordable health care system.
Nebraska Department of Insurance Public Forums
September 2011
The Department of Insurance held public forums throughout the state to allow the public and stakeholders to comment on the implementation of the exchange. The Department of Insurance Director, Bruce Ramge, hosted the forums to promote an open and transparent implementation process with focus on the required planning and development of health insurance exchanges. Most recent forums were held on March 16th in Lincoln, and on March 22nd in Omaha. No additional stakeholder meetings are planned at this time.
Nevada
Nevada Health Care Reform Policy Planning Group
September 2011
The Health Care Reform Policy Planning Group, working toward the implementation of a health insurance exchange, is now focusing on IT development efforts to support implementation. Led by the Director of the Department of Health and Human Services, Mike Willden, other members include the Insurance Commissioner, the Administrator of the Division of Health Care Financing and Policy, and representatives from the Office of the Attorney General, the State Insurance Division, Risk Management, the Public Employees Benefits Program, the Governor's Office of Consumer Health Assistance, and the Division of Welfare and Supportive Services. The Planning Group's most recent meeting was on July 21st - the next meeting date has not been announced.
Nevada Health Care Reform Implementation Working Group
September 2011
The Health Care Reform Implementation Working Group was tasked with determining what effect the PPACA will have on Medicaid. It is now focusing on the creation of an eligibility engine for the health insurance exchange, rate enhancement, long-term care re-balancing, prescription drug rebates, and patient-centered medical homes. Led by the Administrator of the Division of Health Care Financing and Policy, Charles Duarte, other members include representatives from the Aging and Disability Services Division, the Division of Mental Health and Developmental Services, the Division of Health Care Financing and Policy, the Division of Welfare and Supportive Services, the Division of Child and Family Services, the State Health Division, and the Department of Health and Human Services Director's Office. The Working Group's next meeting has not been set.
New Hampshire
New Hampshire Health Insurance Reform Oversight Committee
September 2011
The Health Insurance Reform Oversight Committee, chaired by Representative Ed Butler (D), has been meeting to discuss implementation of federal health care insurance. The Committee made a summary report on federal insurance reform implementation, together with any recommendation for legislation, to the House Commerce and Consumer Affairs Committee and the Senate Commerce, Labor and Consumer Protection Committee. The Committee has not set a date for its next meeting.
New Jersey
New Jersey Health Care Reform Implementation Council
December 2010
The New Jersey Health Care Reform Implementation Council is proposed through S.B. 2239 and A.B. 3202. The purpose of the Council is to plan for and coordinate the implementation of health care reform in the state, as well as develop and present policy recommendation for the consideration of State agencies, policymakers, health care providers, and third party payees. Both bills are still pending in the Legislature.
New Mexico
New Mexico Health Care Reform Working Group
September 2011
The Health Care Reform Working Group, focused on federal health care reform and health insurance exchanges, was preparing a report for the Joint Legislative Health & Humans Service Interim Committee, and then the full Legislature. The working group last met on October 4th, 2010 to discuss information technology, broadband access, interface with Medicaid, quality, transparency, and reporting, and health insurance exchanges, as well as to obtain public comment. The Working Group was called to reconvene in the 2011 Legislative Session, however, due to state budgetary constraints, funding that allowed for legislative participation in the Working Group has been cut. No attempts have been made to reconvene the Working Group without legislative participation.
New York
New York Health Care Reform Advisory Committee
September 2011
The Health Care Reform Advisory Committee was formed to provide input to the Governor's Health Care Reform Cabinet on reform provisions and to ensure stakeholder and public involvement. It includes 37 organizations representing health care providers, consumers, businesses, organized labor, local governments, health plans, health insurers, and health policy experts. The Advisory Committee will include work groups created to focus on specific issues. Advisory Committee meetings are not open to the public - the date of the next meeting has not been set.
New York Health Care Reform Cabinet
September 2011
The Governor's Health Care Reform Cabinet was created May 13th, 2010 by Governor David Paterson (D). The Cabinet was charged with managing the implementation of federal health care reform including:
Identifying provisions of federal health care reform with which the state must comply, those which are optional, and analyzing the participation in optional programs;
Assessing the state's capacity to carry out the provisions of federal health care reform that affect the state;
Identifying any changes needed to state statute, regulation, policy, or procedure in order to implement federal health care reform provisions;
Communicating with the federal government, local government, or other state health care providers and other stakeholders; and
Providing for outreach to the public to educate them on the implementation of reforms.
Cabinet members include representatives from the Department of Health, the Department of Insurance, the Division of the Budget, the Department of Civil Service, the Department of Taxation and Finance, the Department of Labor, the Office for Technology, the Office of Temporary and Disability Assistance, the Office of Mental Health, the Office of Mental Retardation and Developmental Disabilities, the Office of Alcoholism and Substance Abuse Services, the Office for the Aging, the Office of the Medicaid Inspector General, and the Office of Children and Family Services. Other Cabinet members include the Deputy Secretary for Human Services, Technology and Operations, Deputy Secretary for Intergovernmental Affairs, and Counsel to the Governor. The Cabinet continues to meet, however meetings are closed to the public.
North Carolina
North Carolina Health Benefits Exchange and Insurance Oversight Workgroup
September 2011
The North Carolina Departments of Insurance and Health and Human Services have formed the Health Reform Health Benefits Exchange and Insurance Oversight Workgroup to help advise the agencies and the General Assembly with regard to the health insurance exchange, insurance oversight and the consumer ombudsman program, as well as the coordination of Medicaid and the Health Benefit Exchange. The Workgroup consists of representatives from consumer organizations, health economists, insurance companies, broker/agent organizations, Medicaid and Social Services, and the agencies and is co-chaired by staff from the Departments of Insurance and Health and Human Services. The Workgroup is finalizing proposed legislative language that would establish the exchange and is forming other recommendation for the General Assembly. The Group was scheduled to meet on April 20th and May 25th, however those meetings were canceled. The date of the next Workgroup meeting has not been announced.
North Carolina Health Reform Overall Advisory Group
September 2011
The North Carolina Departments of Insurance and Health and Human Services, in cooperation with the North Carolina Institute of Medicine, have formed the Health Reform Overall Advisory Group to coordinate the work of the eight health reform workgroups that have been created to help with health care reform implementation and to address any cross-cutting issues that may arise. The Advisory Group is co-chaired by Secretary Cansler of the Department of Health and Human Services and Commissioner Goodwin of the Department of Insurance, and includes representatives from the General Assembly, state agencies, insurance companies, health care organizations, and state colleges and universities. The Advisory Group is working on an Interim Report on Health Reform which provides an overview of the health care reform provisions being considered by each workgroup and the progress to date. While the Group met on April 15th; the May 20th meeting was canceled. The date of the next Advisory Group meeting has not been announced.
The eight health reform workgroups over which the Advisory Group presides, include the Prevention, Safety Net, Health Professional Workforce, Health Insurance Exchange and Insurance Oversight, Medicaid, New Models of Care, Quality, and Fraud and Abuse Workgroups. There will be workgroup meetings held between August 26th and November 30th - the New Models of Care Workgroup met on September 6th.
North Carolina Health Reform Quality Workgroup
September 2011
The North Carolina Departments of Insurance and Health and Human Services, along with the North Carolina Institute of Medicine, have formed the Health Reform Quality Workgroup to build on existing efforts to further improve the quality of care in the state. Specifically, the Workgroup will understand the federal guidelines for patient outcome quality measures and reporting requirements; identify strategies to improve quality of care, and; build on existing state quality initiatives. In meetings to date, the Workgroup has identified the gaps between PPACA quality requirements and existing state efforts aimed at improving quality and patient safety, and has begun to address those gaps and explore educational efforts necessary to inform both providers and the public of the new PPACA quality provisions. The Workgroup was scheduled to meet April 11th, however that meeting was canceled. No additional meetings are expected as any further Workgroup discussion will be carried out electronically.
North Dakota
North Dakota Health Care Reform Review Committee
September 2011
The Committee is a 2011-2012 interim committee made up of members of both houses of the Legislature. The Committee will receive regular updates from the Insurance Commissioner with respect to steps taken to ensure health insurer procedures are in compliance with the PPACA. The Commissioner will also update the Committee on proposed legislation for consideration at a special legislative session if the Commissioner is required by federal law to implement any requirement before January 1st, 2013. The Committee will also receive reports from the Commissioner on implementation of an exchange. At a July 7th meeting, the Committee was updated on the status of state implementation of the PPACA and the state of federal Health and Human Services recently released guidelines on the PPACA. They also discussed the National Association of Insurance Commissioners American Health Benefit Exchange Model Act. The Committee's next meeting will be October on 6th & 7th to discuss the impact of the Affordable Care Act with a focus on reviewing proposed legislation creating a state health care exchange.
Ohio
Ohio Health Benefits Exchange Task Force
September 2011
The Health Benefit Exchange Task Force (Task Force) was created in October 2010 to consider issues and provide guidance to the state government on the key decision points and topics related to the implementation of a health insurance exchange. Co-chaired by the Chief Policy Officer at the Ohio Department of Insurance and the Medicaid Director, the Task Force includes consumers, employers, health care providers, insurance carriers, insurance agents, and state officials. The Task force held four meetings throughout Fall 2010. At its October 28th, 2010 meeting, they decided that Ohio should establish its own exchange rather than having the federal government establish and operate an exchange in Ohio. The Task Force made this and other recommendations to Governor-elect Kasich (R) on December 27th, 2010 in a transition document entitled "Transition of Health Exchange Planning to the New Administration." The Task Force is no longer meeting - its future under Governor Kasich's administration is unknown.
Oklahoma
Oklahoma Health Insurance Exchange Workgroup
September 2011
The Oklahoma Health Insurance Exchange (OHX) is an Oklahoma based, public-private partnership created to make health insurance more readily available to individuals without other coverage and to small employers. The Insurance Department, Health Care Authority, and Department of Mental Health and Substance Abuse Services established the state-administered OHX and created a Workgroup to advance the process. The Workgroup is comprised of representatives from various stakeholder groups. A series of meetings were to be held across the state to discuss the necessary characteristics and functions of an exchange in Oklahoma, however stakeholder and workgroup meetings to be held in April and May were cancelled.
Oregon
Oregon Health Policy Board
September 2011
The Oregon Legislature created the Health Policy Board in 2009 and charged it with creating a comprehensive health reform plan for the state. The Board made recommendations to the Oregon Health Authority, the main agency implementing the PPACA, in its blueprint for health care reform and also made recommendations for the Exchange, which were presented to the Legislature during the 2011 session. The Board continues to meet to discuss a strategic plan for PPACA implementation and last met on September 13th.Pennsylvania
Pennsylvania Department of Insurance Exchange Forum
September 2011
The Pennsylvania Insurance Department held three forums in August to gather public input on health insurance exchanges. The Department is interested in input from all parties impacted by the formation of health insurance exchanges. Key areas of focus include: 1) The establishment - state based or federal government; 2) The oversight - how and who should operate and govern, and; 3) The functionality - what functions should it provide and to whom? The forums were held on August 9th in Pittsburgh, August 11th in Philadelphia, and August 23rd in Harrisburg. A video of the forums available online. View PA ForumsPennsylvania Commonwealth Health Care Reform Implementation Committee
September 2011
The Commonwealth Health Care Reform Implementation Committee and the Commonwealth Health Care Reform Implementation Advisory Committee were created by Executive Order of Governor Edward Rendell (D) on May 19th, 2010. The Advisory Committee and Subcommittees have been meeting regarding federal grant initiatives, implementation of insurance exchanges, as well as access and enrollment principles. The Advisory Committee is made up of legislators, and members of both the private and public health care sector. The Committee has not met since January 2011. As the Committee was formed under former Governor Rendell, it is not expected to have a role with PPACA implementation in the future.
Rhode Island
Rhode Island Healthcare Reform Commission
September 2011
Governor Lincoln Chafee (I) established the Healthcare Reform Commission by executive order on January 13th, 2011 with the purpose to help implement the PPACA, although it is not limited to that role. Lt. Governor Elizabeth Roberts will chair both the Commission and the Executive Committee of the Commission. While the Executive Committee will be responsible for implementing the Affordable Care Act, the Commission will provide input. The Executive Committee is comprised of the Lieutenant Governor, the Director of the Department of Administration, the Health Insurance Commissioner, the Secretary of the Office of Health and Human Services, and the Director of the Governor's Policy Office. Members of the Commission were appointed by the governor and were drawn from the medical professions, public health fields, business, and other fields. Directors of state agencies may also be asked to serve on the Commission as circumstances dictate. The Executive Committee met on August 16th - the date of the next meeting has not yet been announced.
South Carolina
South Carolina Exchange Planning Committee
September 2011
The Exchange Planning Committee, established by Governor Nikki Haley (R) under Executive Order 2011-09, operates as an advisory group to assist with necessary research as determined by the Insurance Commissioner and to provide recommendations on the exchange planning process. The Committee is conducting a thorough review and analysis of current and new data on the operation of exchanges, developing an in-depth study and review of alternative approaches to the exchange, and preparing a report to submit to the Governor by October 28th. This report will set forth the Committee’s recommendations regarding whether the State should establish an exchange. The Committee met on June 30th - the next meeting has not been announced.South Dakota
South Dakota Health Insurance Exchange Task Force
September 2011
The Health Insurance Exchange Task Force, chaired by Lieutenant Governor Matt Michels, formulated a strategy by which the state will offer health insurance through an Exchange. The recommendations of the Task Force were sent to Governor Daugaard and considered during the 2011 Legislative session. The Task Force was divided into three subcommittees: 1) Operations and
Finance; 2) Outreach and Communication, and; 3) Insurance Plan and Market
Organization. While the PPACA is unpopular in South Dakota, the Administration views it as prudent to proceed with the implementation. The Task Force and subcommittees met on August 16th and produced recommendations that may be viewed online. View SD RecommendationsTennessee
Tennessee Insurance Exchange Planning Initiative
September 2011
The Tennessee Insurance Exchange Planning Initiative is tasked with investigating whether the state should operate a state-level exchange and, if so, how it might be structured. The Insurance Exchange Planning Initiative has formed two Technical Advisory Groups (TAGs) to help with the insurance exchange planning process. The Actuarial/Underwriting TAG will focus on analytical issues relating to risk pool structure, adverse selection, risk adjustment, and rating areas. The Agent/Broker TAG will focus on operational and market questions, ultimately providing a detailed inventory of options for state decision-makers in the form of discussion papers for public review and comment. Additional TAGs are planned in the future. A Provider and Advocate Roundtable has also been formed to solicit the input of health care providers and advocates regarding the Exchange. A formal advisory group of health care providers will not be formed until the State receives additional federal guidance. The next meeting of the TAGs and the Roundtable have not been announced.
Texas
Check back for future activity updates.Utah
Utah Health System Reform Task Force
September 2011
The Health System Reform Task Force, co-chaired by Representative David Clark (R) and Senator Wayne Niederhauser (R), met and received updates on the Utah Health Exchange. An update on the launch of the Exchange to all small employers and the limited launch to large employers was recently provided to the Task Force. The Task Force also received reports on the coordination of the response to federal health care reform and the implementation of exchanges within that reform. Reports have also been provided to the Task Force on the high risk pool for persons with pre-existing conditions and tax consequences of federal health care reform. The next meeting of the Task Force has not been announced.
Vermont
Vermont Health Benefits Exchange Advisory Group
September 2011
The Vermont Health Benefits Exchange Advisory Group was formed to provide information and feedback toboth the state and the Health Purchasing contractor for Exchange planning, on the design for a Health Benefits Exchange. The Group's input will be helpful for the development of the Exchange implementation grant proposal. Comprised of members of the Vermont Legislature as well as private sector health care organizations, the Group's meetings are open to the public with opportunity for public comment at each meeting. The Group last met on September 12th to discuss options - the presentation is available online. View VT Presentation
Vermont Health Care Reform Commission
September 2011
The Health Care Reform Commission, co-chaired by Representative Steven Maier (D) and Senator Jane Kitchel (D), has been meeting to hear updates from the Department of Vermont Access on federal and state health care reform. The Commission has also been receiving updates on the implementation of both federal and state health care reform, including the high risk pool implementation. The date of the next Commission meeting is not available.
Virginia
Virginia Health Care Reform Initiative Advisory Council
September 2011
The Virginia Health Care Reform Initiative Advisory Council was established to provide recommendations to the Governor on a comprehensive strategy for implementing health care reform in Virginia. The Advisory Council reviewed everything from reforming Medicaid and the delivery and payment system, to improving electronic health records and established task forces in six key areas: 1) Medicaid reform (including the need for coordination for care for all participants); 2) service delivery (including management of chronic diseases); 3) health insurance regulations (looking at statutory changes needed to implement the national health care reform legislation mandates); 4) workforce (examining capacity and education issues); 5) health information technology, and; 6) purchasers' perspective (assessing employers' interests as health insurance purchasers). The Council released its report to the Governor on December 20th, 2010. Final options and recommendations are due to the Governor and General Assembly by October 1st, 2011.
Washington
Washington Exchange and Insurance Reforms Advisory Group
September 2011
The Exchange and Insurance Reforms Advisory Group and the Joint Select Committee on Health Reform Implementation have been meeting regarding policy questions and initiatives regarding federal health care reform to be addressed. The Joint Legislative Select Committee, chaired by Representative Eileen Cody (D), has been receiving reports and testimony from numerous working groups charged with the consideration of specific health care policy initiatives to be implemented. The Committee has also heard testimony regarding cost-containment and low-income coverage in the state. Workgroups reported their final findings and recommendations to the Committee on November 30th, 2010. The legislation establishing the Advisory Group was to expire in July 2011, however the Advisory Group was reauthorized by the legislature to continue its work on the development of Washington’s response to the PPACA. The next meeting of the Advisory Group has not been announced.
Washington Health Care Authority Advisory Committee
September 2011
The Health Care Authority created a technical advisory committee to assist with the development of exchange policy issues. The Committee will provide feedback to the Health Care Authority on key exchange policy options and issues leading up to the 2012 legislative session. The next Committee meeting has not been announced. West Virginia
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Wisconsin Special Committee on Health Reform Implementation
September 2011
The Special Committee on Health Reform Implementation, co-chaired by Representative Pat Strachota (R) and Senator Alberta Darling (R), has been meeting to discuss the implementation of federal health care reform. The Special Committee has discussed organizational matters and has received presentations from various policy groups. Formed as a interim study committee for the 2010-2012 period, the Special Committee is expected to present a report to the Legislature at the end of this time. The next Committee meeting has not been announced.
Wyoming
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