Date: 03/01/2012
Final
Presentation on the CO Health Benefit Exchange
COMMITTEE ON JOINT HEALTH AND HUMAN SERVICES
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01:37 PM -- Presentation on the Colorado Health Benefit Exchange
Gretchen Hammer, Chair of the Colorado Health Benefit Exchange Board of Directors (board), Richard Betts, Vice-chair of the Colorado Health Benefit Exchange Board of Directors, and Patty Fontneau, Executive Director of the Colorado Health Benefit Exchange (exchange), introduced themselves to the committee. Copies of their presentation and the 2011 progress report on the implementation of the exchange were distributed to the committee (Attachments A and B).
01:40 PM
Ms. Hammer discussed the activities of the board. She noted that Senate Bill 11-200 created the board and dictated the makeup of the membership of the board. She discussed the specific requirements for members who serve on the board, and noted that a list of the board members is included in Attachment A. She described the Legislative Implementation Review Committee and discussed the hiring of Ms. Fontneau as Executive Director of the exchange.
01:45 PM
Ms. Hammer discussed the stakeholder engagement process used by the board, and noted that all of the board meetings are open to the public. She noted that the exchange recently received an establishment grant and discussed the activities that will be carried out with the grant moneys. She provided an update on the technology services that will be part of the exchange. Ms. Hammer noted that the board is researching and discussing a number of policy decisions for successful implementation of the exchange by 2014.
01:48 PM
Ms. Fontneau thanked the board and the members of the Implementation Review Committee, and noted that there has been active stakeholder input in the activities of the exchange. Mr. Betts commented on the activities of the board. Ms. Fontneau responded to questions from Senator Mitchell regarding the implementation of the federal Affordable Care Act. Ms. Hammer and Ms. Fontneau responded to additional questions regarding exchanges in other states and the implementation of navigator services in the exchanges. Mr. Betts and Ms. Hammer responded to questions from Senator Nicholson regarding how the exchange will address the unique needs of rural Coloradoans. Ms. Fontneau responded to questions from Senator Lundberg regarding how the exchange will interact with the Colorado Benefits Management System, and Mr. Betts commented on how the exchange will determine eligibility for public health programs.
02:04 PM
Ms. Hammer responded to questions from Representative Kefalas regarding whether the exchange will combine the small group and individual insurance pools, and she explained that the board has decided to structure the exchange as one administrative entity with two separate lines of business for the individual and small group markets. She explained that the individual and small group risk pools will remain separate and noted that the board will study how managing the risk pools separately will affect the insurance marketplace. Representative Kefalas asked what role the board will have in determining the essential health benefits that will be offered by the plans in the exchange. Ms. Fontneau responded that the board and the exchange are working closely with the Division of Insurance (DOI) and interested parties in open meetings regarding the essential health benefits. Representative Kefalas asked what the current status of the exchange is in light of the case pending before the U.S. Supreme Court challenging the federal Affordable Care Act, and Ms. Hammer referenced Senate Bill 11-200's legislative declaration that finds that establishing the exchange is in the best interest of the state of Colorado.
02:10 PM
Ms. Hammer responded to questions from Representative Acree regarding the certification process that will be required for insurance plans sold through the exchange, and noted that the exchange may not duplicate the functions of the DOI. Representative Joshi asked about the requirement that the exchange be financially self-sustaining by 2015 and Ms. Hammer responded. She further responded to questions regarding the effect of the exchange on CoverColorado and Getting Us Covered, Colorado's high-risk insurance pools. She stated that, when the exchange is fully implemented, an estimated 460,000 individuals and 80,000 employees and dependents of employees of small employers will enroll in coverage through the exchange and will utilize premium assistance and tax credits to pay for the coverage. An additional 160,000 individuals and 260,000 employees and dependents of employees of small employers will enroll in coverage through the exchange without financial assistance for the costs of the coverage. Ms. Hammer further responded to questions from Representative Kefalas regarding whether the exchange will include a navigator function.
02:19 PM
Ms. Fontneau responded to questions from Senator Mitchell regarding whether tax credits for employers are available only through the exchange. She further responded to questions from Senator Mitchell regarding whether there are elements of Colorado's exchange that would not have been included if there were not federal requirements to do so. Ms. Hammer responded to questions from Representative McCann regarding how the essential health benefits offered in plans in the exchange will be determined and from Representative Kefalas regarding medical-loss ratios in health plans. Senator Nicholson asked if there was an available estimate of how many individuals will remain uninsured if the U.S. Supreme Court rules the individual mandate unconstitutional and Ms. Hammer responded that an estimate is not currently available.
02:26 PM
Senator Boyd thanked Ms. Hammer, Mr. Betts, and Ms. Fontneau for their presentation.