Individual Health Insurance Reform Weekly: EasyToInsureME : 08/17/09

Week of August 17, 2009 : EasyToInsureME

The highly charged health care reform debate continues to get extensive news coverage, and Members of Congress are clearly feeling the heat. Senate Finance Committee Ranking Member Senator Charles Grassley (R-IA) took the unusual step of issuing a statement last week to reassure voters that a Finance Committee bill will not have end-of-life provisions -- one of the more controversial topics at town hall meetings this summer. A Finance Committee bill has yet to emerge, as Committee members search for an approach that can net bipartisan support. But Grassley provided a small glimpse of the Committee's thinking when he disclosed that the panel "dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly." Distancing himself and the Finance Committee from the House bill, Grassley went on to say House legislation is "poorly cobbled together" and could invite unintended consequences.

Federal

With Congress in recess, there is no federal report this week.

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States

NEW JERSEY: Newly enacted legislation requires installment payment for maternity services, and it mandates the Department of Banking & Insurance to promulgate a payment schedule for provider services rendered in advance of child delivery. Through the New Jersey Association of Health Plans, Aetna and other carriers will meet with stakeholders to assist the department in implementing this statute. Also enacted into law was an autism coverage mandate. Under the new statute, insurance carriers must extend coverage for medically necessary treatment including speech, occupational, and behavioral therapy. The coverage benefit is capped at $36,000 annually. Also, the state Supreme Court has denied an appeal for stay of approved rider filings by the Small Employer Health Benefits board. A coalition of health care providers, primarily ambulatory surgery centers, sought to delay implementation of an approved rider filed by Horizon Blue Cross Blue Shield of NJ, which limits out-of-network ASC benefits at $2,000. The newly appointed Commissioner of Banking & Insurance denied the providers’ appeal for stay. The coalition's emergency request for delay was denied by the Appellate Division and finally the Supreme Court upheld the denial.

NORTH CAROLINA: The Governor has signed the proposed budget with no premium tax increase to insurers, thanks to the input of Aetna and many other industry leaders, business leaders and trade groups. Previous budget proposals included increases from 1.9 to 2.25 percent, effective January 2011.

PENNSYLVANIA Health Insurance : Governor Ed Rendell signed a budget bill after exercising his line item veto to strike most appropriations other than those necessary to pay state employees. The bill, introduced by Senate Appropriations Committee Chairman Jake Corman (R-Centre), was passed without amendment so that it could go to the Governor. The 2 percent managed care organization tax remains the big open issue for the budget. Moving the current MA MCO assessment under the sales and use tax is supported by some, but the administration is pushing the added 2 percent tax on all managed care premiums.