The implementation of health insurance exchanges (HIX) is one that contains a plethora of variables. While more than 30 states have opted to allow the federal government to take control of their HIX, other states, such as Mississippi and Utah, continue to seek ways to implement the exchange without ceding total control.
made headlines earlier this week when Insurance Commissioner Mike Chaney was informed by the federal government that the state’s proposed HIX had been rejected on Thursday, making Mississippi the only state to date to have their plan denied by the federal government.
The rejection stems from an ongoing battle between Chaney and Mississippi Governor Phil Bryant; although Chaney had continued to press the effort to move forward with the state-based exchange, Bryant has opposed it from the onset. According to the HHS, the chasm between Chaney and Bryant was a factor in the decision to reject the proposal. Kaiser Health News adds that
“Chaney began building the exchange
in Mississippi based on his authority to run the state’s high risk pool. One problem with that is it has nothing to do with Medicaid — only subsidized private insurance. The Affordable Care Act says that the exchanges have to be one-stop shops for both private insurance and Medicaid. As insurance commissioner, Chaney doesn’t have access to Mississippi’s complicated Medicaid enrollment processes.” Federal rules state that a coordination strategy with other agencies must be developed and documented, something that proved problematic for Chaney based on the aforementioned restricted access to Medicaid enrollments.
Governor Gary Herbert has been trying to come up with his own spin on a HIX in his state: a partnership whereby the state runs half and the federal government the other half. Utah has a unique situation in that they already have in place a HIX for small businesses; however, the current setup does not meet all the requirements that the federal government has outlined, and state legislators have not signed off on changes that would achieve compliance. Therefore, Herbert is proposing that the current state-run exchanges continue to operate the small-business part s of the exchange, leaving the federal government to handle operations for offering individuals qualifying coverage.
According to the Wall Street Journal,
HHS spokeswoman Erin Shields Britt said that a discussion between Herbert and HHS Secretary Kathleen Sebelius was “productive,” and that Sebelius “wants to continue to be as flexible as possible within the confines of the law and HHS will continue working closely with state officials moving forward.”
Around the Web
Feds reject proposed Mississippi health exchange [Sun Herald]
HHS Denies Mississippi’s Bid To Run Its Own Exchange [Kaiser Health News]
Utah Offers to Split Health Insurance Exchange [Wall Street Journal]
Utah, HHS in Talks to Split Health Insurance Exchange [Becker’s Hospital Review]