Tag Archive: South Dakota

Iowa governor exploring interstate health benefit exchange with 3 adjacent states

Iowa Governor Terry Branstad wants to confer with governors of three neighboring states about setting up an interstate health benefit exchange marketplace. Iowa and the other states –South Dakota, Nebraska and Kansas — have opted to have the U.S. Department of Health and Human Services initially operate their exchanges.

Branstad reportedly cited the fiscal benefit of sharing exchange operating costs and the presence of Iowa health plan issuers Wellmark Blue Cross and Blue Shield and CoOportunity Health in the other three nearby states.

Section 1311(f) of the Patient Protection and Affordable Care Act authorizes the operation of “Regional or Other Interstate Exchanges” operating in more than one state, subject to the approval of the involved states and the federal Department of Health and Human Services.

The Quad City Times has the full story here.

See also this analysis of Affordable Care Act provisions that would enable less populous states like Iowa to join with other states to form larger pools of potential individual enrollees, generating better spread of risk for health plans and increasing the purchasing power of exchange member states with plan issuers.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Iowa, South Dakota Blues Skip Obamacare Exchange Next Year – Capsules – The KHN Blog

The fewer insurers that sell through exchanges, the less competition there will be for customers through price and service. Many insurers are approaching the exchanges cautiously because of concerns that the technology may not be ready and that the first customers will be disproportionately sick and expensive, analysts say.

via Iowa, South Dakota Blues Skip Obamacare Exchange Next Year – Capsules – The KHN Blog.

This is the key paragraph of the story relative to its implications for these and other state exchanges next year, particularly in smaller states where the absence of a major plan issuer can adversely affect the ability of the exchanges to attract individuals and small employers.

Participation in the exchange marketplace is voluntary for sellers and buyers.  But it won’t function as intended to make coverage more affordable and of better value unless it can generate sufficient economies of scale from both sides of the market.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

South Dakota legislation would restrict sale of multi-state health plans

South Dakota lawmakers advanced a bill that would restrict the marketing of multi-state health plans (MSPs) to the state’s health benefit exchange, barring their sale outside the exchange market.  Senate Bill 139 would also require MSPs be sold exclusively by state licensed insurance producers and mandates producers be paid commissions on a par with similar plans sold outside the exchange.

Section 1334 of the Patient Protection and Affordable Care Act requires at least two MSPs be offered in each state exchange.  The MSPs will be phased in over a four-year period starting when the exchanges begin operating in 2014, when MSPs must be in 60 percent of the states.

Regulated by both the federal government and the states, MSPs are intended to increase competition and consumer choice, particularly in less populous states such as South Dakota where there are fewer health plans available.  However, existing plan issuers and producers in these states likely fear MSPs will have a disruptive impact on the market and potentially crowd out smaller players by virtue of their interstate heft and superior economies of scale.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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