Health Reform Weekly

A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country.


Week of April 15, 2013

With implementation of the Affordable Care Act (ACA) fueling concerns about rising health care costs, a new and diverse coalition of organizations announced last week its
consensus recommendations for improving health care quality while lowering costs. Calling itself the Partnership for Sustainable Health Care, the group has five primary recommendations: transform the way health care providers are paid to emphasize value over volume; pay for care that is proven to work; encourage consumers to choose high-quality care; improve the nation’s health care infrastructure; and provide incentives for states to improve care. The group includes advocates for employers, insurers (America’s Health Insurance Plans), consumers, health care providers and others.

In related news, new research from the Robert Wood Johnson Foundation offers fresh evidence that the percentage of employers offering health care coverage to their employees dropped significantly in the past 10 years. Rising health care costs are thought to be one of the most significant factors in the decline. 


ARIZONA: As Governor Jan Brewer held yet another rally last week in support of expanding Medicaid, sentiment in the legislature appears to have shifted in favor of the measure making it more likely that it will pass. In contrast to prior events featuring support from business and health insurance leaders, the most recent rally focused on mental health professionals and the population they serve. Republican leadership continues to voice concerns, but some party members are expressing confidence in the governor’s ability to achieve the two-thirds vote that may be needed to pass in each chamber, due to the proposal’s provider tax.

CALIFORNIA: The California Medical Association is sponsoring legislation that would increase health care premiums by instituting a new $5 dollar assessment per member on health plans annually. Under their proposal, the assessments would fund additional grants for graduate medical residency training programs. The proposed assessment would cost the health care system about $100 million annually and would come on top of the many taxes and assessments plans and insurers already pay. In addition, the ACA is imposing new taxes and fees on insurers, as is the state’s health insurance exchange. In order to participate in the exchange, plans and insurers must pay an assessment of about 3 percent of premiums. The legislation is opposed by Aetna, other health insurers and business organizations.

FLORIDA: House Speaker Wil Weatherford announced last week his proposed alternative to the Medicaid expansion proposal voted down last month. Called Florida Health Choices Plus, the plan builds on Florida Health Choices, the insurance marketplace created five years ago by statute for individuals and small businesses. It would cost the state $237 million annually and would not require any federal funds. The proposal would cover an additional 115,000 uninsured, including childless adults and the disabled. Coverage would require individual contributions of $25 per month, with taxpayer contributions amounting to $2,000 annually per account. With little time remaining before the May 3 adjournment, it's unclear whether the plan will gather much support.

MARYLAND: The General Assembly adjourned last week after debating numerous health care-related bills this session, including exchange-related legislation and numerous pharmacy-related issues. Exchange legislation was passed by both chambers and will be sent to the governor for his signature. The Maryland Health Progress Act of 2013 implements multiple provisions of the ACA, including Medicaid expansion, establishment of a state reinsurance program, high-risk pool phase-out and numerous operational aspects of the exchange. Importantly, the bill creates a sustainable financing mechanism for the exchange. Funding will come from the existing premium tax and will not include new assessments or taxes.

OHIO: The House of Representatives has eliminated Medicaid expansion language from Governor John Kasich’s budget proposal. Citing lack of clarity in the federal requirements and disagreement over extension of Medicaid coverage, legislators eliminated the expansion from the budget and included language that would prohibit expansion of the Medicaid program. It was estimated that the expansion for adults up to 138 percent of the federal poverty level would provide insurance coverage to 275,000 Ohio residents and result in a cost savings to the state of $400 million over the next two years. In response to the action by the House, over 2,000 consumer advocates, providers, and business people held a rally at the Statehouse to encourage support for the expansion. The House is likely to finalize its work on the budget and send it to the Senate for consideration by the end of April.


Health Reform Connection
America's Health Insurance Plans
Aetna 2011 Annual Report 

Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. Those companies include Aetna Health Inc. and Aetna Health Insurance Company, 151 Farmington Avenue, Hartford, CT 06156.

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