Health Care Exchange (04/29/2015)

Final
STAFF SUMMARY OF MEETING

HEALTH CARE EXCHANGE

Date:	04/29/2015	ATTENDANCE

Time:	07:31 AM to 08:35 AM	Aguilar	*
		Kefalas	X
Place:	RM 271	Landgraf	X
		Lundberg	*
This Meeting was called to order by		Martinez Humenik	*
	Senator Roberts	Primavera	*
		Ryden	X
This Report was prepared by		Sias	E
	Amanda King	McCann	X
		Roberts	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Opening Remarks and Update from Legislative Council Staff Update from the Subcommittee Concerning the Executive Director Presentation on Health Exchanges from NCSL		Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only

07:32 AM -- Opening Remarks and Update from Legislative Council Staff

Senator Roberts called the meeting to order. She reviewed the meeting agenda (Attachment A). A document containing comments provided by the Colorado State Association of Health Underwriters (Attachment B) was distributed to the committee members.

150429 AttachA.pdf

150429 AttachB.pdf

07:33 AM

Bill Zepernick, Legislative Council Staff, provided an update on the public feedback survey received via the committee's website, www.Colorado.gov/LCS/ExchangeReviewComm, from April 9 through April 24, 2015 (Attachment C). He highlighted issues that were raised in the survey responses, including concerning with the shared eligibility system, the difficulties with completing the enrollment information or changing enrollment information, and the challenges in receiving the proper tax forms.

150429 AttachC.pdf

07:35 AM

Mr. Zepernick discussed Senate Bill 15-256, concerning the operation of the legislative committee that oversees the Colorado health benefit exchange. He stated that under the bill the committee could meet up to seven times during the interim. Mr. Zepernick referenced the committee's interim meeting schedule (Attachment D). Senator Roberts requested a summary sheet for the public feedback survey received. Senator Roberts discussed the committee's schedule for meetings during the interim.

150429 AttachD.pdf

07:37 AM -- Update from the Subcommittee Concerning the Executive Director

Senator Kefalas provided an updated on the April 17, 2015, meeting of the subcommittee concerning the appointment of the chief executive director of Connect for Health Colorado (the exchange). The subcommittee's meeting summary (Attachment E) was distributed to the committee members. A list of salaries for various Connect for Health Colorado employees was provided in the subcommittee's meeting summary. Senator Kefalas stated that Gary Drews, interim chief executive director for Connect for Health Colorado, is leaving the exchange in May and that the previously announced executive director candidate withdrew his name from consideration.

150429 AttachE.pdf

Senator Roberts said that the Connect for Health Colorado board will present at the May 13, 2015, committee meeting. She disbanded the subcommittee. Senator Kefalas discussed members being supportive in making the exchange successful and sustainable. Senator Lundberg and Senator Kefalas discussed the amount of money spent on the chief executive director and chief financial officer searches. Senator Roberts reiterated that the exchange's board and staff will present at next committee meeting.

07:43 AM -- Presentation on Health Exchanges from NCSL

Richard Cauchi, Program Director of Health Programs, National Conference of State Legislatures (NCSL), presented to the committee. He reviewed information about NCSL. He provided an informational packet on health exchanges (Attachment F) to the committee members.

150429 AttachF.pdf

07:47 AM

Mr. Cauchi discussed the various types of health exchanges operating throughout the country, which include 14 state-based exchanges, three federally supported marketplaces, seven state-partnership marketplaces, and 27 federally facilitated marketplaces. He highlighted information about various state-based exchanges, such as states with high enrollment numbers, states that have positive impression of operations, states with high re-enrollment numbers, and states experiencing technology challenges.

07:53 AM

Mr. Cauchi provided information about enrollment and re-enrollment numbers throughout the country. He highlighted the advertising and outreach efforts of state-based exchanges.

08:00 AM

Mr. Cauchi discussed the other states that have legislative reporting requirements for their exchanges, which include Massachusetts, Hawaii, New Mexico, Rhode Island, and Connecticut. He referenced the increased public disclosure and transparency related to health exchanges and health insurance. He highlighted anticipated changes to state exchanges in 2015, especially potential changes in Arkansas, Massachusetts, New Mexico, and Illinois.

08:07 AM

Mr. Cauchi reviewed information about the differences between exchange eligibility and Medicaid eligibility. He referenced the technology progress and challenges related to health exchanges. He discussed the federal platform, HealthCare.gov. He shared information about the various federal Department of Health and Human Services' regulations, guidance, and regional offices. Mr. Cauchi stated that NCSL is available as a resource for information about the federal regulations and federal entities related to health exchanges.

08:12 AM

Mr. Cauchi discussed the fiscal sustainability of state health exchanges. He referenced the federal grants provided to states for work related to health exchanges. He highlighted information about Connecticut's exchange being a possible model for a health exchange. Mr. Cauchi outlined possible insurance reforms that could impact health exchanges. He responded to some of the questions provided in advance by committee members (Attachment G).

150429 AttachG.pdf

08:19 AM

Mr. Cauchi referenced the case currently pending before the federal Supreme Court concerning health exchanges, King v. Burwell. He discussed the State 1332 Innovation Waivers, which allow states to find alternative ways to meet the insurance coverage goals.

08:22 AM

Mr. Cauchi responded to questions about the information he presented on the enrollment numbers. In response to a question, he discussed the status of the exchanges in Oregon, Nevada, and New Mexico. Mr. Cauchi discussed the terms and conditions for states to receive federal grant funds for establishing state-based exchanges. He dialogued with committee members about the flexibility that states have to make changes to their exchanges and whether states may need to refund federal funds in certain circumstances.

08:35 AM

The committee adjourned.