The National Association of Insurance Commissioners (NAIC) will hold its Summer National Meeting from August 14-17 in Seattle addressing a wide range of critical issues affecting producers, including licensing, federal regulation, health insurance and managed care, and natural disaster preparedness. PIA National’s Executive Vice President & CEO Len Brevik and Assistant Vice President David Eppstein will attend the meetings. Brevik will build on the conversations he had with commissioners this spring on how PIA can be a partner with the NAIC to keep making progress on modernizing state-based insurance regulation.

Many of the sessions and much of the discussion during the upcoming NAIC meeting will focus on what the states are having to do to implement the Patient Protection and Affordable Care Act (PPACA), the new federal healthcare law. The law stipulates that many of the reforms it requires will be carried out by the states, not the federal government. That has put state insurance regulators on the front lines of implementing the new law. It will also require various actions by state legislatures.

Most provisions will not take effect until Jan. 1, 2014. However, some new protections must be implemented when plans renew after Sept. 23, 2010 and states must begin to take certain actions now. The new federal high risk pool program has just been formed and greater transparency will be required of health care plans in the coming months. Section 1101 establishes an interim high-risk pool program to provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition. The law establishes a temporary national high-risk pool to provide health coverage to individuals with pre-existing medical conditions. The high risk pool provision of the federal law became effective 90 days after enactment, on June 21, 2010.

During PIA’s meetings with legislators and regulators, we identified several key areas that states must begin working on now:

1. States should begin meeting with interested parties and form task forces to help them implement the new health care law.
2. States must begin to gather data on the nature of their markets, such as number of uninsured and underinsured and the nature of their current market.
3. State regulatory agencies will have to coordinate with their legislatures to identify statutory authority that may be necessary. Model laws should consider what state agency is best equipped to implement the new law. PIA National recommends that states utilize their existing departments and rely heavily on the insurance department.
4. States should decide now whether they will apply for grants from HHS to conduct the research necessary to determine what kind of exchange, if any, would be best for their citizens. HHS announced the availability of up to $1 million in grants per state to help states begin work to establish exchanges.

Each state has the option to establish and operate its own exchange or partner with another state or states to operate a regional exchange. If a state decides not to create an exchange for its residents, HHS will help establish one on their behalf.  HHS is interested in hearing from us. PIA National will be providing comments to the NAIC, NCOIL and HHS on the nature of health exchanges. Our main goal will be continuing to allow state regulators to have the flexibility to set up the type of exchange that will best suit their consumers.

Preserving the Role of Agents in Healthcare: PIA will continue to be involved in all the discussions surrounding implementation of the new health care law at the NAIC. One of our key goals for this meeting is to meet with the regulators and work with them to preserve the role of the independent agency system in health insurance delivery. We will also be partnering with our regulators to help them answer any questions they may have about setting up exchanges in their state.

States Implement Reforms of Healthcare As Lawsuits Proceed (The Hill 8/6/10)

August 9, 2010