States can choose whether to keep or kill the arrangements they have been using to prevent health insurance-related job lock.
Officials at the Center for Consumer Information & Insurance Oversight (CCIIO) have delivered that verdict in one of several answers given in a new batch of answers to questions about the new Patient Protection and Affordable Care Act (PPACA) health insurance exchange (HIX) program.
PPACA requires the U.S. Department of Health and Human Services (HHS) to work with state officials to make the exchanges, or Web-based insurance supermarkets, available in all 50 states and the District of Columbia by Oct. 1.
CCIIO — pronounced “Sih-Sigh-Oh” — is the agency helping HHS set up the exchange system.
CCIIO is an arm of the Centers for Medicare & Medicaid Services (CMS), which is, in turn, an arm of HHS.
One major CCIIO answer is a response to the following question: ”Given the guaranteed availability requirement in 2014, what does this mean for states with alternative mechanisms?”
The question has to do with the arrangements states have made to implement the major health system change law that came along before PPACA, the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
To keep lack of access to individual health coverage from locking sick people (or relatives of sick people) with group health coverage into jobs they want to leave, the drafters of HIPAA included a provision that requires states to make some kind of guaranteed-issue individual health coverage available to residents who leave group health plans and are unable to qualify to buy new individual coverage.
Some states have provided coverage access using “risk pools,” or subsidized programs designed to cover the medical bills of people with health problems.
Other states have required one, some or all of the insurers in their individual markets to provide all coverage or some kind of coverage on a guaranteed-issue basis.
PPACA itself calls for insurers to sell all individual coverage that takes effect on or after Jan. 1, 2014, without considering individual health information.