Let’s say the Supreme Court strikes down the individual mandate but leaves the rest of the reform law intact. Within minutes, headlines on Fox News and The Drudge Report will likely declare: Obamacare Ruled Unconstitutional! States that that haven’t yet enacted legislation to build an exchange would probably slam on the brakes. In a nice bit of irony, states that most strongly oppose big government would be inviting big government to move in set up shop…and to set up SHOP (Small Business... Read more

In a bulletin released late Friday Feb. 24, CMS’s Center for Consumer Information and Insurance Oversight gave proponents of account-based health plans some good news by suggesting that employer contributions to health reimbursement arrangements (HRAs) and health savings accounts (HSAs) could be taken into account when determining actuarial value of qualified health plans (QHPs) and nongrandfathered small-group and individual policies. But it doesn’t look like contributions made by account... Read more

The White House last week hailed 28 states — led by both Republican and Democratic governors — that “are on their way toward establishing” a health insurance exchange. So far, HHS has issued three rounds of establishment grants, collectively worth up to $729 million. But states might run out of time long before they run out of money. In less than a year, HHS must certify state insurance exchanges, which will begin enrolling members 10 months later and become operational on Jan. 1, 2014.... Read more

Most people who closely follow health policy were a bit surprised by HHS’s decision to side-step the development of a national essential health benefits (EHBs) standard and instead push that work onto the states. Despite being an industry-shaping issue, the 13-page bulletin surfaced quietly on a Friday afternoon in December with little fanfare. Even more interesting was that it wasn’t on HHS or CMS letterhead. And no one I interviewed about this issue seems to know what exactly what the term “... Read more

Shortly after the reform law was enacted, some industry observers predicted that state insurance exchanges would operate like Orbitz and other online travel sites…and insurance agents and brokers would disappear just as travel agents did during the last decade. But buying health insurance through a Web portal will be vastly more complex than booking a ticket to Las Vegas or renting a car. Particularly during the first year or two, executives involved in building exchanges agree that agents and... Read more

A pair of reports released in October confirm that one or two behemoth health insurers — typically a Blues plan — control at least half of the market in most states. But insurance commissioners as well as those heading state insurance exchange initiatives say they’re optimistic that the new marketplace will help attract new competitors. In Mississippi, for example, the state Blues plan controls 55% of the overall managed care market, while UnitedHealth has 23%, according to data released late... Read more

In anticipation of the retail market that state insurance exchanges will create in 2014, some health plan operators are trying to recast themselves as consumer-friendly entities focused on helping members improve the quality of their lives. UnitedHealth Group, for example, launched a campaign late last summer called "Health In Numbers," which is designed to help people better understand the role the insurer can play in helping them “get back to the lives they want to lead,” says spokesperson... Read more

While a few states have rejected federal funding to build insurance exchanges, many more states are assembling boards that will help develop and lead their exchanges. California's Health Benefits Exchange recently named Peter Lee its first executive director. Most recently Lee was director of delivery system reform in the HHS’s Office of Health Reform. The Maryland Health Benefit Exchange appointed Rebecca Pearce its executive director. She previously was a national product director at Kaiser... Read more

The person who — over the past year — became the public face of insurance exchanges will step down Sept. 23. Joel Ario has headed the Office of Insurance Exchanges since it opened its doors last August. Insurance commissioners and various stakeholders that I interviewed were surprised that he would opt to leave such a critical role at a pivotal point in the development of state insurance exchanges. Exchanges need to be certified by HHS by Jan. 1, 2013, and operational a year later. Steve... Read more