States regulators mulling alternative paths to PPACA (AP Photo/Charles Dharapak)

The NAIC has formed a new working group comprised of state insurance commissioners in order to create a forum for the many states that, yielding to political gubernatorial pressure or for other reasons, are not adhering to the formal state health care exchange implementation path outlined in the Patient Protection and Affordable Care Act (PPACA).

The group was organized on August 13 at the NAIC’s National Summer Meeting in Atlanta.

Michael Consedine, Pennsylvania’s insurance commissioner, stated that the group is “not a forum to throw grenades at ‘Obamacare.’” 

Many of the commissioners present, though, come from states that have been hostile to many elements of PPACA and its statutory deadlines that are required if states want to control their health care exchanges.

The new group, the Health Care Reform Regulatory Alternatives (B) Working Group, vice-chaired by Wisconsin Commissioner Ted Nickel, addresses the concerns of the many states who are expected to have the federal government work in concert or in full with them to create the PPACA-mandated health care exchanges.

Consedine noted that there is a need for the group, as more than half of the states have chosen a different route in dealing with PPACA, which includes, for states, implementing state health care exchanges and addressing Medicare expansion funding.

One of the charges is to “identify opportunities for members to continue to innovate and regulate outside of a federal exchange.”

There are no members yet, but the NAIC is going to circulate a notice to see who wants to join

One of the four charges is to analyze the impact of PPACA on existing member regulatory authority both inside and outside of a federal exchange. The work on exchanges has long been underway in a handful of states and has been delayed or rejected in many others since the reform law passed in 2010 and was upheld in June 2012 by the U.S. Supreme Court.  

The group is also supposed to assist regulators in resolving open issues with regard to non-state exchange PPACA alternatives.

It also hopes to examine PPACA’s impact on NAIC Model Laws such as the Unfair Insurance Practices Act, Producer Licensing Model Act and Model Law on Examinations.

Apparently, Nickel had spoken at length a day earlier — he had told the regulators and interested parties assembled, including Health Committee Chair and Kansas Insurance Commissioner Sandy Praeger as well as NAIC President Kevin McCarty of Florida and Vice President Adam Hamm of North Dakota, that he had  “calmed down” from the day before, an observer wrote. 

On Sunday, at the NAIC meeting, Nickel had reportedly recited for Department of Health and Human Services officials, including Michael Hash, interim director, Center for Consumer Information and Insurance Oversight and others assembled, a list of marketplace changes that Wisconsin had implemented on its own without any federal involvement, those present reported.