‘Exchange Final and Interim Final Regulations’ Released

Hello all,

Some of you may know that I was appointed to the Governors Exchange Task Force Adverse Selection Working Group. Quite a mouthful but it does allow me as the only insurance agent to bring forth the concerns of my profession and you as our clients and constituents. While I don’t agree with the Obama and Dayton administrations that we need an exchange, I believe it is vitally important that a sense of reason be brought to the table and that we don’t let this lead to a single payer system. Many of the things that have been discussed in these meetings have given me the impression that our government does not want the private market outside of the mandated exchanges to exist in the future. This will result in rationing of care and long delays in service as has happened in Massachusetts as the result of their exchange the “Connector” . Premiums inside the Connector are 4% higher than the private market alternatives because of the cost of operation the Connector. And people have had long waits to see a primary care provider and in some cases have begun to see doctors in neighboring states.

I was at a meeting a couple of weeks ago with the COO of the Minnesota Exchange being developed by Governor Dayton and was told that in order to make the exchange in Minnesota more competitive that the state must levy a general tax to cover the cost of operating the exchange. The ACA states that the exchanges must be self-sufficient within 2 years of 1-1-2014. The state of Minnesota Department of Commerce apparently believes that a general tax is within the rules of the ACA. This obviously puts the private market at an extreme disadvantage. Since I am a former baseball player I will make an analogy. It would be like forcing one team to use whiffle ball bats while the other used high tech aluminum bats. There is no way anyone on the team using the whiffle ball bats could compete regardless how talented they are.

Last week the Federal HHS came out with their “Exchange Final and Interim Final Regulations” this is a 646 page document delineating all the requirements of the operation of state or federal exchanges. Keep in mind that these exchanges must be set up by 1-1-2013 or the Federal government will set in and set up a federal exchange. I would also like you to keep in mind that the Minnesota legislature is only in operation until May. It would seem to me that Governor Dayton believes he has the right to enact the exchange without legislative approval. Is this the first step to being a dictator? You be the judge.

Here is a link to the exchange rules if you wish to spend the next year understanding the setup and operation of exchanges.

http://www.ofr.gov/(X(1)S(cvt0vdg0bvvffj0yiikczaef))/OFRUpload/OFRData/2012-06125_PI.pdf

Minnesota (HF479) Exchange

Minnesota (HF479) Exchange

Hello All

In recent weeks there has been a bill proposed to implement the “Exchange” in Minnesota (HF479).  This bill consists of a minimalist approach to the exchange requirement mandated to the states by the Obamacare legislation.  This bill is designed with as much private market protections as the Obamacare law allows.

Some staunch conservatives don’t want any bill creating an exchange to be passed.  They reason that since the Federal Court in Florida ruled the individual mandate to be unconstitutional and the law to be unseverable that the entire law is unconstitutional and cannot be enforced. The judge did not however formally enjoin the Federal government from continuing to implement the law.  Judge Roger Vinson has been asked formally by the Obama administration to specify whether they can continue the implementation process that they have already begun.  We should have an answer to this question in the next few weeks.

On the surface I would agree.  I abhor the idea of the exchanges and the costs involved in the implementation of such a requirement.

I think that any good plan includes dealing with the law as it is and working toward completely eliminating the law and implementing real reform that concentrates on the cost of healthcare and inequities in the system.  With this in mind hopefully the Federal government will be enjoined from implementation and the Supreme Court will strike down the law.  We cannot expect in Minnesota, since Mark Dayton is our governor and we have DFL attorney general, that we will follow suit with Florida and Alaska in refusing to implement, according to the law’s timeline, Obamacare.  I also do not believe that Governor Dayton will return the federal money sent to MN to establish the Exchange as Wisconsin, Florida, and Vermont have done (all Republicans).

In addition, if HF479 is not passed, Governor Dayton may decide to implement an exchange designed by him and his staff as five other governors’ have done with no input from their legislature.

To me designing these programs with a minimalist approach is like having seatbelts in your car.  We hope we will never need them but we have little control over what other drivers may do.  We need to drive our cars and we must protect ourselves and our loved ones to the best of our abilities.

Without these protections we leave ourselves open to disaster.

Please call your state representatives and senators to voice your support for HF479.

Dave Wiest
President
EMEX Benefits