House Republicans and Republican state officials have been fighting to block implementation of the Patient Protection and Affordable Care Act of 2010 (PPACA) and funding of PPACA implementation.
The Republicans at the House Ways and Means Committee health subcommittee took a different approach — objecting to what they are delays in efforts by the U.S. Department of Health and Human Services (HHS) to implement PPACA — Wednesday at a hearing on implementation of the PPACA health insurance exchange regulations and related regulations.
One of the witnesses who appeared at the hearing Wednesday, Michael Consedine, the Pennsylvania insurance commissioner, talked about the effects of the delays on state regulators.
While talking generally about areas of confusion, he raised questions about what could be a huge new PPACA-related program — the multi-state plan (MSP) program — and whether MSPs could end up having an unfair edge over traditional single-state plans.
If HHS runs a state’s exchange program “will the multi-state insurance plans be required to adhere to all applicable Pennsylvania insurance laws?” Pennsylvania asks in an appendix included with a written version of his remarks posted on the Ways and Means website.
Nevada exchange organizers recently complained about having to make decisions about their state’s exchange program without having all of the answers they would like from HHS.
At the Ways and Means hearing, Consedine said HHS itself put about 100 references to regulations or batches of advice that were still in the works in the final rule on setting up an exchange. HHS still has not published any of those regulations, Consedine said.
Two weeks ago, Pennsylvania sent HHS Secretary Kathleen Sebelius a list of 26 questions about the exchange program, including the questions about MSPs, Consedine said.
“As of the date of this testimony, HHS has not responded to our letter,” Consedine said.
States do not know, for example, how much say they will have and how much say HHS officials will have over a state’s “essential health benefits” benchmark, or the set of requirements that describes the benefits that a plan sold through an exchange must offer, Consedine said.