By Sarah Kliff, health care reporter, Politico
HEALTH EXCHANGES – Starting in 2014, every state will have a new marketplace (think of it as an Expedia for health insurance). If states have not made sufficient progress on an exchange by 2013, Health and Human Services will come in and do the job for them.
STORY IDEAS
- Reach out to the Governor’s office to find out whether he/she supports running an exchange or leaving the task to HHS
- Profile legislators who are pushing exchange bills-or, alternatively, those who are obstructing a state-run exchange
- Explain what the exchange in your state will look like: will it allow all insurers to sell on the new market, for example, or contract with those with best value?
INSURANCE RATE HIKES – The Health Policy law has given state insurance commissioners new resources to review and push back against premium increases. Any rate increase over 10 percent will be reviewed, either by a state or HHS, to see if it is “unreasonable.”
STORY IDEAS
- How are insurers reacting to the new scrutiny? A business story could look at how their world has changed post-Health Policy.
- 45 states got “rate review” grants from HHS. How have they been used?
MEDICAL LOSS RATIO WAIVERS – Many states are pursuing waivers from a part of Health Policy called the “medical loss ratio,” which requires insurers to spend at least 80 percent of premiums on medical costs (as opposed to administration or profits).
STORY IDEAS
- Is your state applying for a waiver? Reach out to your state insurance commissioner to find out their current position
- Insurance companies and health insurance brokers are good sources for a story about what they’re doing to lobby for a waiver application.
Where To Go For More Information
- The National Conference of State Legislatures (www.ncsl.org) has a database to track all state-level Health Policy legislation
The National Academy of State Health Policy’ State Refor(u)m site (www.statereforum.org) is a great database of what each state is doing on Health Policy issues
