The state countdown: Fate of exchanges after the election
Just days after the November elections, states will have to make final (or reasonably final) decisions about whether they are going to run their own health insurance exchange and what that will look like – or whether the federal government will take responsibility for all or part of the exchange.
States also are grappling with decisions about the essential benefits packages, and although there’s no deadline, expect the pace of their Medicaid expansion decision making to pick up after elections.
If President Obama is re-elected, states will probably pick up the pace of implementation. If Mitt Romney wins, they will probably anticipate repeal – but what happens to all the preparatory work they’ve been doing for the past two years, and will it contribute to new state-based solutions that Romney says he wants? We’ll talk to three experts who are doing hands-on work with both “red” and “blue” states.
Joel Ario, managing director, Manatt Health Solutions
Cheryl Smith, director, Leavitt Partners
Moderator: Joanne Kenen, AHCJ topic leader/health reform; deputy health care editor, Politico Pro
Joel Ario is a managing director of Manatt Health Solutions, an interdisciplinary policy and business advisory practice of Manatt, Phelps & Phillips, LLP. He has more than 30 years of experience helping to shape and implement public policy, including more than 15 years devoted to leading health insurance reform efforts at the state and federal government levels. Ario provides strategic consulting and policy analysis to assist state governments, health plans and foundations in preparing for the implications of healthcare reform, with a particular emphasis on implementing health insurance exchanges. He previously served as director of the Office of Health Insurance Exchanges at the U.S. Department of Health & Human Services (HHS), where he led efforts to implement provisions of President Obama’s health care reform initiative. He was the administration’s point person for standing up health insurance exchanges. Prior to his federal service, Ario was Pennsylvania insurance commissioner. He served on the executive committee of the National Association of Insurance Commissioners (NAIC) for a decade and was elected three times to as an NAIC officer. He was also president of the National Insurance Producer Registry for two years and executive director of the Oregon State Public Interest Research Group for seven years.
Heather Howard is a lecturer in public affairs at Princeton University and director of the State Health Reform Assistance Network, a program funded by the Robert Wood Johnson Foundation. She served as the commissioner of health and senior services for New Jersey, where she was responsible for oversight of public health services, regulation of health care institutions, hospital financing, senior services, and health care policy and research. Her prior public policy experience includes work in the U.S. Senate and House of Representatives, for the Domestic Policy Council at the White House, and for the Health Care Task Force within the Antitrust Division at the U.S. Justice Department.
Cheryl Smith is a director at Leavitt Partners, where she helps guide the firm’s health insurance exchange practice. Smith worked in the Utah Governor’s Office of Economic Development as the director of the Utah Health Exchange office. There she played a central role in Utah’s Health Insurance Exchange, one of only two functioning state health insurance exchanges in the country. Her leadership and expertise drew national attention as Utah’s health insurance exchange was recognized in the Washington Post, The Boston Globe, The Wall Street Journal, Forbes.com, and BusinessWeek.com. Smith was a Visiting Health Policy Fellow at The Heritage Foundation in Washington, D.C. While at Heritage she focused her research, analysis, and writing on the State Children’s Health Insurance Program (SCHIP), Medicare drug pricing, and state health system reform.
Joanne Kenen is AHCJ’s health reform topic leader. She is leading an effort to provide resources to help AHCJ members cover the complexities of implementing health care reform by writing blog posts, tip sheets, articles and other resources. Kenen is a Washington-based writer who specializes in health and health policy. Her work has appeared in the Atlantic, The Washington Post, Slate, the Washingtonian, Kaiser Health News, Health Affairs, Miller-McCune, the American Prospect, AARP Magazine and numerous other publications. She was the senior writer for the Health Policy Program at the New America Foundation, and a Kaiser Media Fellow in 2006-07, where she wrote extensively about palliative medicine, hospice and aging. A longtime Reuters correspondent in New York, Florida/the Caribbean and Washington, she has covered everything from voodoo festivals to U.S. presidential campaigns and she spent more than a decade covering health policy on Capitol Hill. Thanks to her particularly wakeful second son, she is co-author of a parenting book, "The Sleeplady's Good Night, Sleep Tight." Earlier in her career, she did a lot of reporting from Latin America and co-authored a book on Costa Rica.