Health Insurance Reform Weekly : EasyToInsureME : July 16th 2009

On the health care reform front, the Senate HELP Committee continues to slug it out amendment by amendment, with Democrats winning all of the important ones on straight party-line votes. The HELP Committee started the week by unveiling its new language on the public plan and the employer mandate, but it still has no language on biogenerics. The committee hopes to complete this work by week's end. The Finance Committee has yet to meet to mark up a bill because it doesn't have a bill as yet - the Chairman is still seeking a bipartisan compromise with Republicans. The long-awaited beginning of the Finance Committee mark-up will have to wait until the following week at the earliest. The House-planned introduction of its bill was postponed until early this week, which puts off the beginning of the House mark-up until later in the week. It seems clear that the Democratic leadership is seeking to convey the impression that progress is being achieved, while having to deal with constant rumblings that the bills simply cost too much for even Democrats to accept. While the House surely has the capacity to meet its goal of having a bill ready for floor debate by mid-July, it is unlikely that Speaker Pelosi will allow this without an expectation that the Senate also will debate a bill before the August recess, set for August 7 in the Senate.

States
ARIZONA Health Insurance : In the wake of the failed 2008 ballot "Medical Choices Act" initiative, the legislature passed a resolution proposing to amend the Arizona Constitution to state that "no law or rule shall compel a person, employer, or health care provider to participate in any health care system, including a prohibition of penalties or fines for direct payment of lawful health care services." The amendment would also state that "the purchase or sale of health insurance in private health care systems shall not be prohibited by law." The resolution was certified for the 2010 general election. Additionally, the legislature passed and sent to the Governor a proposal to limit the benefit mandates that apply to the individual market; the proposal awaits the Governor's signature.

CONNECTICUT Health Insurance : As anticipated, Gov. M. Jodi Rell vetoed two of the most significant and flawed pieces of legislation approved this year by the legislature. The first, the Connecticut HealthCare Partnership bill, would have opened the very expensive state employee health plan to small businesses and other groups on an unregulated, self-insured and financially risky basis. The second would have set in motion a fully state-run health care system in Connecticut by implementing the "SustiNet Plan." Either measure would be very costly to taxpayers, especially with the state facing a projected $8.85 billion budget deficit over the next two years. The legislature may attempt to override these vetoes in a "veto session" scheduled for July 20. A veto override requires 101 votes in the House and 24 votes in the Senate - all 24 Senate Democrats would need to be present on a summer day to enact the override. The Democrats have only overridden one of Rell's vetoes during the past five years. The insurance industry has advocated for an alternate concept for expanding health coverage. That plan also would create an insurance pool, but the plan would permit insurers to offer coverage rather than forcing people to use a public pool.

Governor Rell has also issued an Executive Order creating a 15-member Connecticut Health Care Reform Advisory Board to develop a set of health care policies in response to federal reform initiatives. These proposals are directed at emphasizing cost containment, maximizing federal matching funds, enhancing access to preventative care, and assuring coverage for all children. The board is required to make interim recommendations by Feb. 1, 2010 and submit final recommendations to the Governor and General Assembly by January 1, 2011.

MASSACHUSETTS Health Insurance : Harvard Pilgrim Health Care President Charlie Baker announced that he is pursuing the 2010 GOP nomination for Governor of Massachusetts, and will be leaving his job at Harvard Pilgrim Health Care. Baker is seeking to unseat incumbent Democratic Gov. Deval Patrick. Patrick was elected the state's first African American governor in November 2006, ending a 16-year run of Republican control over the Executive Office. State Treasurer Timothy Cahill may also be in the mix as he announced he is leaving the Democratic Party and weighing an independent candidacy for governor. Cahill has been espousing a fiscal conservatism usually voiced by Republicans. Bruce Bullen, Harvard Pilgrim's current chief operating officer, will become interim chief executive officer.

NEW YORK Health Insurance : After more dramatic developments late last week, the deadlock in the Senate was finally broken and the Senate immediately began passing bills. More than 100 were moved through the process in one night. As expected, the Senate voted to make the state's mental-health parity law (Timothy's Law) permanent. They did not take up any other health industry issues. The way toward legislative action was paved when breakaway Democrat Senator Pedro Espada announced he would rejoin the Democrats, giving them the needed 32-30 majority over Senate Republicans. Sen. Espada will be the Senate Majority Leader, and Senator Malcolm Smith will serve as the Senate President. The scope of their authority in those roles is undefined at this time, as ordinarily those titles are held by the same Senator. The Senate plans to be back in session on Wednesday, July 15, to address several local municipality bills. The complete calendar of bills has yet to be made public.

NORTH CAROLINA Health Insurance : Key legislators have heard from numerous interested parties regarding the proposal to increase premium taxes across all lines of insurance from 1.9 percent to 2.25 percent, effective January 1, 2011. Because of the strong opposition to the tax, alternatives measures continue to be discussed. Aetna is working with all interested parties to defeat the new taxes.

Ohio Health Insurance : The state's budget woes continue as the deadline for the interim budget expired on July 7. Governor Ted Strickland signed a second seven-day extension through July 14, giving the legislature additional time to craft a bipartisan plan. But, with the ongoing stalemate between the Governor and the Senate over video lottery terminals, the conference committee has been unable to engage in any substantive discussion regarding the deficit. Instead, Senate President Harris forwarded a letter and a joint resolution to the Governor calling for a ballot vote in November. It is unclear what the next step will be. Health industry issues, including open enrollment program changes, electronic claims payment, a dependent age increase and administrative expense reporting, remain in limbo.