Judul : New York Health Benefit Exchange
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New York Health Benefit Exchange
bjbjvwvw jeffrey brown: and we turn to anissue that loomed large before and throughout the election campaign, the survival of obamacare,the health care reform law. with democrats retaining control of the white house and thesenate, the questions now, how will the law work, and to what extent will states participate?ray suarez has our update. ray suarez: the law allows many uninsured americans to buynew coverage beginning in 2014 through new
New York Health Benefit Exchange, marketplaces known as health care exchanges.states can set up their own federally subsidized exchanges or opt to let the federal governmentrun one for them. so far, at least 17 states, plus the district of columbia, will set uptheir own. but some 20 others, many led by republican governors, won't and may leavethe task to the federal government. five others
want to partner with the administration. sixhave not decided on a path yet. state officials also say they have been waiting for federalrules on a whole host of provisions, including what insurers must cover as essential healthcare benefits. the obama administration released some of those regulations today. for a lookat where things stand, i'm joined by susan dentzer. she's the editor of the journal "healthaffair" and an analyst for the newshour. and, susan, the election is over and some of theambiguity about what to do about the affordable care act i guess has gone away now that thespeaker has said it's the law of the land. has all the dust settled? is it settling?susan dentzer: it slowly beginning to settle, ray. as you said, lots of regulations wereissued today. more will be forthcoming in
the coming weeks. and, of course, some ofthe big questions, what will happen with respect to medicaid expansion, remain undecided. butessentially what we have now is a situation where, as we said, a number of states aremoving ahead to set up their health insurance exchanges. these will be websites in effectup and running, ready for open enrollment on oct. 1 of 2013. so it's literally justaround the corner. ray suarez: they have a extended the deadline for opting in or out.are there some states that are on the bubble that may yet come in with this extension?susan dentzer: yes, very clearly. the states now have until mid-december to tell the federalgovernment what their plans are. and if they want to set up an exchange in partnershipwith the federal government, they have until
the middle of february to tell the federalgovernment that. and then, of course, even if states make a preliminary decision now,they are allowed to change their minds at any point in the future. if they decide twoyears down the road from now that they want to open up a state-based exchange, they havethe authority under the law to do that. ray suarez: so, if you're sitting at home watchingthis and you live in one of the some 20 states that have either made it absolutely clearthey're not participating or are very likely to finally make that decision, what happensto you? susan dentzer: you will be able to access health insurance anyway through anexchange that the federal government will either set up in your state... ray suarez:so, that's a market? susan dentzer: yes, it's
a market. for -- the bulk of consumers shouldthink of this as a website. that's how they will really interface with these exchanges,much the way they go online now to travelocity or another website to set up travel arrangements.it will be a similar kind of a thing. so, you will go -- if you're in a state wherethe governor or the legislature has decided not to go forward with an exchange, you willhave one anyway. it will probably be called the name of your state. you just won't knownecessarily that it's actually run by the federal government and specifically by federal-- private contractors who the federal government has engaged to actually operate the exchange.there's also the possibility of a nationwide exchange being formed as well, a federal backupexchange. the federal government hasn't said
a whole lot about that, but that's possiblyin the offing as well. ray suarez: now, did the administration contemplate when they werepainstakingly setting up the architecture for the affordable care act that they mayhave to go into run the exchanges for almost two dozen states? susan dentzer: they certainlydid contemplate it. and that's why shortly after the law was signed, they got to workdiscussing how to do this, basically hiring the private sector vendors that will be puttingthe exchanges together. and they're prepared to do it. \ keep in mind that, under the medicaredrug benefit program, the federal government has a kind of a similar setup now that allowedpeople to begin to select their drug coverage policies under medicare several years ago.so it's not a really particularly exotic thing
for the federal government to be doing, eventhough it's never done anything on quite this scale. ray suarez: is there a paradox embeddedin all this, that governors who adamantly insisted that they didn't want the federalgovernment nosing around in their affairs have, by refusing to participate, essentiallyinvited the federal government in to run these marketplaces? susan dentzer: there is indeeda paradox. and a further one is that the states are insisting that they want to be able tocontrol and manage their health insurance policies that are sold within the state. andjust today, members of the administration insisted that that's what they want too. theywant the states to set up these exchanges. they want the states to be deciding whichplans can come into the exchange. the states
have the option of running these in a veryrigorous way, where they negotiate with health insurers very hard on what the prices willbe, or they can take a more hands-off approach and let more plans come in and not negotiateso hard. but states have the ability to make those decisions. and, as i say, the federalgovernment said, you should. you should. states, you should do that. we would rather you dothat than us come in and pick your plans. so, it is ironic. ray suarez: you mentionedearlier that the federal government announced some new rules today on various parts of theaffordable care act. they made two big announcements on drugs and on pre-existing conditions. whatdid they have to say? susan dentzer: well, the big announcement on the essential healthbenefits was to change what the plans in every
state, the benchmark plan, that is to say,the plan that will be the standard package of benefits offered in every state, in eachstate. they said that -- earlier, the administration had contemplated that those plans would onlyhave to offer one drug, one medication in each particular class of drugs. they revisedthat just slightly today and said it actually has to be either one drug or, if the statepicks a benchmark plan that has more than one drug in every class, then that becomesthe minimum. so it's a little bit more choice. and this was an important issue for patientadvocacy groups that are worried about chronic illnesses and things like that. they wantto make sure that patients have the ability to pick one or more drugs, because sometimesone given drug in every class doesn't work
as well for everybody. so having a littlebit more choice was attractive to them, and the administration has acceded to that. raysuarez: and pre-existing conditions? susan dentzer: preexisting restrictions that -- essentiallyratified what had been known already, which is that as of 2014 those will go away. therewas a little bit more detail on some other aspects of regulations, for example, new agerating rules. now health insurance plan pricing, which used to be quite broad depending onwhether you were younger or older, now has to be much more limited. a plan for an olderperson can only be about three times more expensive than for a younger person. so thoserules were clarified, and how those rating bands as they're called are set were clarifiedtoday. ray suarez: susan dentzer, thanks for
joining us. susan dentzer: great to be withyou, ray. judy woodruff: find out what kind of health exchange plan your state is building.go online to see our interactive map. h(pn gd(pn h(pn gd(pn h(pn :p(pn urn:schemas-microsoft-com:office:smarttagsstate urn:schemas-microsoft-com:office:smarttags place jeffrey brown: and we turn to an issuethat loomed large before and throughout the election campaign, the survival of obamacare,the health care reform law normal microsoft office word jeffrey brown: and we turn toan issue that loomed large before and throughout the election campaign, the survival of obamacare,the health care reform law title microsoft office word document msworddoc word.document.8
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