Sunday, February 10, 2013

DHHS letter to Chaney. Chaney responds.

Here is the letter issued to Insurance Commissioner Mike Chaney by DHHS concerning the health insurance exchange:

Centers for Medicare &Medicaid Services

Center for Consumer Information and Insurance Oversight
200 Independence Avenue SW
Washington, DC 20201

February 8,2013


Mike Chaney

Commissioner of Insurance, Mississippi Insurance Department
501 N. West Street, Suite 1001
Woolfolk Building
Jackson, Mississippi 39201

Rc:Mississippi State-based Exchange Blueprint Application

Dear Commissioner Chaney,

Thank you for submitting a State-based Exchange Blueprint application on behalf of the State of
Mississippi. We completed our review and have determined that we will not be able to
conditionally approve your application at this time, because of the Mississippi Governor's stated
intent to oppose implementation of a State-based Exchange.

Based on the authority in section 1321(b) of the Affordable Care Act, the Exchange Blueprint
details requirements for approval as a State-based Exchange. As stated in the Exchange
Blueprint, "[a] State's Declaration Letter must be signed by the State's Governor".' In addition
to this, the Exchange Blueprint requires that a State-based Exchange has developed and
documented a coordination strategy with other agencies administering Insurance Affordability
Programs and the SHOP that enables the Exchange to carry out the eligibility and enrollment
activities.' With a lack of support from your Governor and no formal commitment to coordinate
from other State agencies, we do not see a feasible pathway to conditionally approving a State-
based Exchange in Mississippi for 2014.

Although we are unable to conditionally approve your application at this time, we are impressed
by the work you have completed to date and encourage you to submit an application for the
Partnership Exchange model by February 15,2013. The work your Insurance Department has
done thus far to ensure that Mississippi maintains broad authority over its health insurance
market makes Mississippi an excellent candidate for a State Partnership Exchange.

Thank you again for submitting a State-based Exchange Blueprint application on behalf of the
State of Mississippi. We look forward to having discussions with you and your staff about the

I. See Blueprint at p. 6.

2. See Blueprint at p. 26 (Table Section 3 .2). 12.pdf

Partnership Exchange model and believe that this provides an additional opportunity for
Mississippi's Insurance Department to take part in the implementation of a health insurance


Gary Cohen
Center for Consumer Information and Insurance Oversight

The Commissioner issued this press release:

The federal Department of Health and Human Services, lead agency for health care exchanges in the country, said Thursday that Mississippi’s long-running plans to develop a state-based health insurance marketplace, was denied.

Mississippi has long led the nation in plans to develop a free market exchange.

To be successful, the Mississippi exchange would need working relationships with other state agencies, which is not possible. HHS stated, “The exchange blueprint requires that a state-based exchange has developed and documented a coordination strategy with other agencies administering Insurance Affordability Programs,”. The letter goes on to say that with a lack of support from the governor and no formal commitment to coordinate with other state agencies, HHS “does not see a feasible pathway to conditionally approving a state-based exchange in Mississippi.”

Under the federal health law enacted in 2010, every state is required to have a health insurance exchange so people can get coverage starting in January 2014, much of it federally subsidized. States that don't create their own will have one run by Washington, with enrollment beginning October 1, 2013.

Commissioner Chaney submitted an exchange proposal to the U.S. Department of Health and Human Services in mid-November which was praised by HHS in the denial letter. “We are impressed with the work you have completed to date,” Cohen says in the letter.

The Mississippi Insurance Department will continue to work with HHS in the future to develop a free market state-operated small business exchange independent of and not connected to any Federal program. This would be an effort to alleviate some of the health insurance problems faced by the state’s small business owners. This would be a free-market approach to solving some of the state’s insurance problems faced by small businesses


Shadowfax said...

It would seem that the ball sits squarely in the court of Feel Bryant. Maybe he can climb down out of his rhinestone saddle and play governor for a few days.

Anonymous said...

Cut the 13th check

Anonymous said...

13th cut two months ago.

Anonymous said...

So, to be philosophically consistent, I'm expecting Phil not to apply for any federal funds for disaster relief as it would add to the deficit and dependency on the federal government is bad.

Anonymous said...

Phil Bryant is a JOKE! Playing at being governor is what he does! He probably stayed at a Holiday Inn last night!

Shadowfax said...

Hello! I'm Feel Bryant........

Anonymous said...

Governor Bryant is right to be concerned about the expansion of federal power in our lifetimes, but our state is not in any economic condition to 'go it alone'. National power has many causes that beyond the responsibilities of our state executive. His political party organization has the responsibility to define the course of national power in their electioneering on the national level. Governance is his duty in our case which means making it work even if you disagree with the law.

Anonymous said...

Well said 6:24 am!

I would add as well that if I wanted to bring down a powerful government and lacked the military might to accomplish it, my strategy would be to create divisiness,dissent and distrust among those governed and among the political entities within that government so that government would be unable to function to solve problems. I would seek to undermine the institutions and make sure the infrastructures deteriorated.

Anonymous said...

8:03 AM has just defined the Kenyan's strategy to the letter.

Anonymous said...

Regarding tornadoes, Bryant opined earlier today that 'We Mississippians work together to solve our problems'. Wondering if he meant that to apply to dilemmas like 'The Exchange'.......

Naw..."We don't need no damn Fedrul gubment down here".

Anonymous said...

the 13,000 licensed insurance brokers wish to earn a living

Anonymous said...

Are they not earning a living now?

Anonymous said...

The bottom line here is this;the federal government CAN NOT get a single letter or other mail from one house to the next without going in the "red". What makes anyone think they can administer a medical insurance program? this gov't insurance deal is bad business

Anonymous said...

Whether the exchange is federally run or "state-run", it cannot possibly succeed. Therefore, even assuming a "State-run" exchange would really be run by Mississippians with some discretion (which it wouldn’t), why would Mississippi want to participate in something that is doomed? When costs sky-rocket above projections, the Feds only choice will be to start squeezing the insurers by requiring them to participate in the exchange at reduced rates in order to sell insurance to the rest of us outside of the exchange. Eventually, the difference in the cost between non-exchange procured insurance and exchange bought insurance will be so large that the average family will not be able to afford insurance outside of the exchange. The political pressure to let everyone into the heavily subsidized exchange will then be overwhelming. At that point, the exchange will be declared a failure and we will go to a single payer system which, many liberals candidly admit, has been the goal all along.

However, assuming the Feds can create a federally run exchange in Mississippi without our State government’s cooperation (a major assumption), there is a huge advantage to the State of not running its exchange. The ObamaCare law exempts employers from the tax required of them when their health insurance plans do not meet all the federally mandated coverage requirements (e.g., coverage for birth control, abortions, sex-change operations and the like), but only if that employer’s state does not have a state-run exchange. Thus, like the employers in the more than 30 states that have rejected having a state-run exchange (including all our neighbors except Arkansas), absent a state-run Chaney ObamaCare exchange Mississippi employers will not have to pay the ObamaCare tax. That’s a big deal.

Thank you Governor Bryant for looking out for those of us who work for a living.

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Trollfest '09

Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).

Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.

In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.

Note: Security provided by INS.

Trollfest '07

Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

Note: Security provided by INS