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 September 16, 2013

A new USA Today/Pew Research Center poll has found that opposition to the Affordable Care Act (ACA) remains strong among consumers, who remain confused over many of the law’s particulars. However, the outlook for the law’s new health insurance exchanges may have brightened a bit last week when federal officials announced that the computer system behind the operation of exchanges nationally has successfully completed security testing and is now ready to go.  Concerns about the system’s readiness and security were fueled last month by the inspector general for the Department of Health and Human Services who said that testing had fallen behind schedule and might not be completed until the 11th hour on September 30.

Also, a new
Reuters/Ipsos poll of uninsured Americans found that the exchanges may attract enough healthy young adults to offset the cost of covering older, sicker Americans and keep the new system afloat financially. While just one-third of young adults polled said they were very or somewhat likely to buy insurance through an exchange, many fear even worse results. Reuters reported that if even half of the young healthy adults who said they are likely to buy insurance follow through, it would be enough to meet the administration’s goal of getting 2.7 million young adults signed up.


Leadership has announced that the House of Representatives may be in session during the week of September 23-27, which was scheduled originally to be a district work period.  This decision was prompted by uncertainty surrounding efforts to pass a “continuing resolution” to keep the federal government funded and running when the new fiscal year begins on October 1.  Efforts to defund the ACA through the annual appropriations process are continuing to complicate passage of the continuing resolution and raise the possibility of a government shutdown. Similar difficulties will face members of Congress next month when the debt ceiling is expected to be reached requiring Congressional action.


ARIZONA: Supporters of Medicaid expansion won a major victory last week as opponents failed to secure the required 86,000+ signatures on petitions for a 2014 ballot referendum on the measure. Although implementation of the expansion can now move forward, the issue is far from settled. The conservative think tank the Goldwater Institute has indicated that it will file a lawsuit contending that legislators who supported the expansion improperly ceded their taxing authority to the executive branch, in violation of the constitutional requirement for separation of powers. The allegation is based on the fact that funding for the expansion will come from an assessment on hospitals by the Arizona Health Care Cost Containment System (Medicaid agency). The Goldwater Institute will argue that the assessment is, in reality, a tax that can be imposed only by the legislature on a 2/3 majority vote.

Information on exchange premium rates for PPOs became available publically last week.  The rates for the five participating insurers, including Aetna, range from a low of $71 to a high of $1,749 a month before factoring in applicable federal subsidies. The average monthly cost will be between $225 and $334.

CALIFORNIA: The state’s health insurance exchange, which has received nearly $1 billion from the federal government to set up an insurance marketplace expected to enroll 5 million residents by 2019, is opening three customer service centers that will employ 1,200 people across the state.  Enrollment by the end of 2014 is projected to be close to 1 million residents.

ILLINOIS: When the state partnership health exchange started its work, consumer awareness research showed that 80 percent of consumers were unaware of the changes coming in the next year, according to Brian Gorman, Director of Outreach and Education for the Illinois Health Insurance Marketplace.  Consequently, the state sought the assistance of the professional marketing team Fleishman Hilliard to help them develop strategies to help reach consumers. The resulting plan included an improved website, digital media and tools for tracking progress and monitoring success.  The improved website will be up and ready for the start of open enrollment on October 1. However, unlike other states, the administration has indicated that it will not be releasing any exchange rate, network and plan information before October 1. 

KANSAS: The state Department of Insurance has unveiled its new website,, providing information for those interested in obtaining health insurance either on or off the new exchange.  Highlights include an interactive program nicknamed “Alex” that helps viewers learn about the 2014 health insurance changes and their potential impact; a premium estimator that will calculate premium costs and potential tax credits for individuals and families; and a link to the federally facilitated health Insurance marketplace. Information is also available about Kansas Navigator programs, insurance agents and other forms of assistance featuring personal help with understanding the health reform law’s provisions.

NEW JERSEY: Health and Human Services Secretary Kathleen Sebelius made a visit to the Garden State last week for a press conference announcing a partnership with Rite Aid pharmacy to help the uninsured enroll in health care coverage through the new health insurance marketplace.  Secretary Sebelius indicated that prices and plans for products to be sold in New Jersey will be available at the end of September. In legislative news, Governor Christie conditionally vetoed legislation requiring the disclosure of claims experience for the State Health Benefits Plan (SHBP) and School Employee Health Benefits Plan (SEHBP) respectively.  While indicating support of the legislature’s intent, the governor cited a need for Joint Insurance Funds to also produce claims in the same manner as the SHBP and SEHBP.  The governor said this additional step would afford local governments the opportunity to consider all their health coverage options. 


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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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