In state budget news, the governor will release his May revision to the
state budget next week, taking into account new revenue figures that
show the state taking in more than $2 billion in unanticipated new tax
dollars. The governor still believes that asking voters to extend the
higher tax rates set to expire
this summer is the right thing to do because the higher revenue
forecasts would not close the entire budget shortfall. Republicans,
however, have been quick to argue that higher revenue forecasts mean
that extending tax rates is not needed at this time.
CONNECTICUT: The legislative session adjourns June 8, but the legislature has yet to reach a conclusion on several major issues, including an exchange bill, a rate review bill and the SustiNet bill. Although the SustiNet compromise bill language is not public, the Administration and press reports have said that the bill does not include a public option but would create an advisory board on health reform implementation and examination of future state reforms. In addition, an anti-most favored nation clause bill has passed the House and now goes to the Senate for its consideration. Aetna supported the bill with amendments. The bill is expected to pass. Additionally, the recently released HHS rate review rule may push legislators to advocate for adoption of the federal 10 percent trigger for rate review in Connecticut, just in case the federal law is repealed.
DELAWARE: The Department of Insurance (DOI) submitted a medical loss ratio (MLR) waiver application to HHS for its individual health insurance market. The DOI-requested adjustment proposes a three-year phase-in of the MLR as follows: 65 percent for 2011, 70 percent for 2012, and 75 percent for 2013.
GEORGIA: Governor Deal has signed legislation that applies state prompt-pay standards to self-funded plans. Aetna will be working with self-funded customers who have questions about the validity of the new law and its application to their plans, which are generally covered by ERISA. INDIANA: Insurance Commissioner Stephen Robertson submitted an MLR waiver request to HHS seeking relief from the MLR regulation for the individual market and for consumer-directed health plans in both the individual and small group markets. Specifically, for the individual market, Indiana is requesting that the MLR be waived for the individual market through 2014, or, as an alternative, that it be phased in as follows: 65 percent in 2011, 68.75 percent in 2012, 72.5 percent in 2013, 76.25 percent in 2014, and 80 percent in 2015, with an exemption from the MLR requirement until 2014 for new market entrants (defined as those that have not previously sold individual major medical health insurance products in Indiana for the previous 10-year period). For consumer-directed health plans in the individual and small group markets, Indiana is requesting a permanent waiver from the federal MLR requirements.
MAINE: Governor LePage has signed into law an Act to Modify Rating Practices for Individual and Small Group Health Plans. The new law is designed to open up Maine's individual and small-group insurance market to competition. It also is supposed to:
help lower health insurance premiums by broadening Maine's community rating system and allowing insurance companies to base their premiums on a more flexible set of criteria.
allow Maine residents to purchase insurance in four New England states beginning in 2014.
set up a reinsurance pool to cover individuals with serious illnesses. The pool would be subsidized by a covered lives assessment capped at $4 per member per month.
The Maine People's Alliance (a progressive advocacy group), the Maine Democratic Party, and others are looking into the feasibility of initiating a referendum on the new law. In order to get a referendum on the November ballot, opponents would have to file approximately 60,000 signatures with the secretary of state no later than 90 days after the enactment of the bill on May 17, 2011.
CONNECTICUT: The legislative session adjourns June 8, but the legislature has yet to reach a conclusion on several major issues, including an exchange bill, a rate review bill and the SustiNet bill. Although the SustiNet compromise bill language is not public, the Administration and press reports have said that the bill does not include a public option but would create an advisory board on health reform implementation and examination of future state reforms. In addition, an anti-most favored nation clause bill has passed the House and now goes to the Senate for its consideration. Aetna supported the bill with amendments. The bill is expected to pass. Additionally, the recently released HHS rate review rule may push legislators to advocate for adoption of the federal 10 percent trigger for rate review in Connecticut, just in case the federal law is repealed.
DELAWARE: The Department of Insurance (DOI) submitted a medical loss ratio (MLR) waiver application to HHS for its individual health insurance market. The DOI-requested adjustment proposes a three-year phase-in of the MLR as follows: 65 percent for 2011, 70 percent for 2012, and 75 percent for 2013.
GEORGIA: Governor Deal has signed legislation that applies state prompt-pay standards to self-funded plans. Aetna will be working with self-funded customers who have questions about the validity of the new law and its application to their plans, which are generally covered by ERISA. INDIANA: Insurance Commissioner Stephen Robertson submitted an MLR waiver request to HHS seeking relief from the MLR regulation for the individual market and for consumer-directed health plans in both the individual and small group markets. Specifically, for the individual market, Indiana is requesting that the MLR be waived for the individual market through 2014, or, as an alternative, that it be phased in as follows: 65 percent in 2011, 68.75 percent in 2012, 72.5 percent in 2013, 76.25 percent in 2014, and 80 percent in 2015, with an exemption from the MLR requirement until 2014 for new market entrants (defined as those that have not previously sold individual major medical health insurance products in Indiana for the previous 10-year period). For consumer-directed health plans in the individual and small group markets, Indiana is requesting a permanent waiver from the federal MLR requirements.
MAINE: Governor LePage has signed into law an Act to Modify Rating Practices for Individual and Small Group Health Plans. The new law is designed to open up Maine's individual and small-group insurance market to competition. It also is supposed to:
help lower health insurance premiums by broadening Maine's community rating system and allowing insurance companies to base their premiums on a more flexible set of criteria.
allow Maine residents to purchase insurance in four New England states beginning in 2014.
set up a reinsurance pool to cover individuals with serious illnesses. The pool would be subsidized by a covered lives assessment capped at $4 per member per month.
The Maine People's Alliance (a progressive advocacy group), the Maine Democratic Party, and others are looking into the feasibility of initiating a referendum on the new law. In order to get a referendum on the November ballot, opponents would have to file approximately 60,000 signatures with the secretary of state no later than 90 days after the enactment of the bill on May 17, 2011.
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