Health insurance exchange slowly taking shape

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Despite the opposition of tea party activists, Georgia is moving slowly but steadily toward the implementation of a key part of the federal healthcare law — establishing a health insurance exchange for individuals and small businesses.

A task force appointed by Gov. Nathan Deal has been working through the summer and into the fall on developing a framework for the exchange where people could shop for health insurance coverage from private carriers or participate in a high-risk pool.

At its Thursday morning meeting, the outlines of that insurance exchange were laid out to task force members who will be sending their final recommendations to Deal by the end of the year.

The exchange would be a quasi-governmental authority similar to the corporation that runs the Georgia Lottery and would be called the Georgia Health Insurance Marketplace Authority.

The authority would be governed by a seven-member board of directors. The governor would appoint the chairman and two other members of the board while the commissioner of the Department of Community Health, who reports to the governor, would be an ex-officio member – thus giving Deal control of a majority of the board members.

The House speaker and the lieutenant governor would each appoint a board member, and the insurance commissioner would automatically serve on the panel.

The insurance authority would administer separate risk pools for individuals and small businesses with up to 50 employees and would make information about coverage and rates freely available to participants. It would not have the power to negotiate rates with carriers.

The implementation of these insurance exchanges is one of the key provisions of the Affordable Care Act that was signed into law last year by President Barack Obama. The new law is variously referred to as ACA, healthcare reform, or Obamacare, depending upon one’s political point of view.

If a state does not establish its own insurance exchange, the federal government will step in and set up one instead. That’s why Deal, who opposes the healthcare act, had legislation introduced this year — HB 476 – to create a Georgia exchange.

Tea party activists, who equate all health insurance exchanges with Obamacare, objected to the bill and their opposition resulted in the measure being pulled from consideration. Deal then appointed the task force by executive order to begin the process of developing an exchange.

“We’re taking some time to step back and see what’s best for Georgia,” said Blake Fulenwider, Deal’s healthcare policy adviser.

Gerry Purcell, one of the task force members, said the legislation the panel recommends to Deal will be modeled after HB 476, the bill that the tea party faction opposed so strenuously.

In a concession to the tea partiers, however, the suggested legislation will not make any mention of the healthcare act signed by Obama.

“One thing you will not see in the legislation is any reference to ACA,” Purcell said.

Under the proposed legislation, the health insurance authority will be exempted from the state’s open meetings requirements, which means it would be able to meet privately and execute secret agreements with private insurers. That prospect concerned some members of the task force.

“Open meeting requirements would certainly have to be part of the bylaws,” said state Rep. Pat Gardner (D-Atlanta).

There were also some disagreements between task force members over how to handle the conflicts of interest that could arise with the appointment of the board that would oversee the insurance authority.

The board members would be expected to have expertise in health insurance matters, but they should not “be in a position to steer business to their firm or product,” said Cindy Zeldin, director of Georgians for a Healthy Future. “We need to be particularly careful about this.”

Insurance Commissioner Ralph Hudgens countered that if insurance industry experts were excluded from the board because of potential conflicts of interest, “you’ll be pooling your ignorance.”

© 2011 by The Georgia Report

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Tags: ACA , Cindy Zeldin , Gerry Purcell , health insurance exchange , Healthcare reform , Nathan Deal , Pat Gardner