Date: 04/29/2015
Final
Presentation on Health Exchanges from NCSL
HEALTH CARE EXCHANGE
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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.