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:

DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare &Medicaid Services

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

February 8,2013

CENTERS for MEDICARE &MEDICAID SERVICES

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. http://cciio.cms.gov/resources/files/hie-blueprint-11162012.pdf

2. See Blueprint at p. 26 (Table Section 3 .2). http://cciio.cms.gov/resources/files/hie-blueprint-111620 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
Exchange.

Sincerely,

Gary Cohen
Director
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
.

14 comments:

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........

http://www.youtube.com/watch?v=o5pHKI5y8jU

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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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!!!

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