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CCH® BENEFITS — 08/26/11

State Health Care Reform Update

from Spencer’s Benefits Reports: For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. With the passage of federal health care reform, states will have increasing responsibilities in regard to employer-provided health insurance benefits. Spencer’s Benefits Reports continues to provide regular updates about state health care reform.

Connecticut. Gov. Dannel P. Malloy has signed into law seven new health insurance mandates. The state now requires that health plans expand coverage requirements for certain patient clinical trials, breast MRIs, colonoscopies, and prostate cancer screenings. Plans also must provide coverage for bone marrow testing. Another mandate restricts insurance companies from requiring patients to use less expensive alternative brand name or over-the-counter drugs for pain treatment before turning to a more costly brand name drug prescribed by a physician. According to a report by the Council for Affordable Health Insurance, Connecticut had 59 mandates in 2010. For more information, visit http://www.ct.gov/cid/site/default.asp.

Idaho. The federal government has decided that Idaho lacks the authority or resources to adequately regulate health insurance rate increases, so many large health insurance premium increases in the state will come under federal review beginning September 1. The Patient Protection and Affordable Care Act (ACA) mandates that each state establish an annual review process. Beginning this fall, the Centers for Medicare and Medicaid Services will review health insurance premium increases greater than 10% for individual and small-group insurance plans in Idaho. For more information, visit http://www.HealthCare.gov.

Illinois. The federal government has blocked an attempt by the Illinois General Assembly to eliminate potential fraud in the state’s Medicaid system. Last year, the General Assembly passed a bipartisan bill, which required Medicaid recipients to show they had low incomes and were residents of the state. Those changes were to go into effect July 1. However, the Centers for Medicare and Medicaid Services objected to the Illinois reform measures and blocked them from taking effect. For more information, visit http://www.hfs.illinois.gov/.

Kansas. Governor Sam Brownback has announced that he will return a $31.5 million federal “early innovator” grant, which would have helped the state integrate its health insurance databases and policy networks into a user-friendly system in a first step to implementing a health insurance exchange, as mandated by the ACA. Kansas had proposed to build a model system that could be adopted by other states striving to meet the Jan. 1, 2013, deadline for developing an exchange system. “There is much uncertainty surrounding the ability of the federal government to meet its already budgeted future spending obligations,” Mr. Brownback said in a statement. “Every state should be preparing for fewer federal resources, not more. To deal with that reality Kansas needs to maintain maximum flexibility. That requires freeing Kansas from the strings attached to the Early Innovator Grant.” For more information, visit http://www.ksinsurance.org/.

Ohio. The state has begun to establish a health insurance exchange, as mandated under the ACA. States have until 2013 to design the structure of the exchange and the criteria insurance plans must meet to be included. The federal government will create exchanges in states that opt not to create an exchange on its own. Mr. Kasich says the state has received some federal money to plan for building an exchange and will soon apply for more funding. For more information, visit http://www.insurance.ohio.gov/Pages/default.aspx.

For more information on this and related topics, consult the CCH Pension Plan Guide, CCH Employee Benefits Management, and Spencer's Benefits Reports.

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