Blues plans recommend reform law changes

Tools

The Blue Cross Blue Shield Association, with its 39 state-based insurance plans, says the reform law should be amended, and it outlined how to best improve the law during a briefing last week, reported The Washington Post's Wonkblog.

First and foremost, the insurance giant wants the U.S. Department of Health & Human Services to issue all the regulations required by the reform law, including rules addressing essential health benefits and details about how health insurance exchanges will work. BCBSA should get its wish for at least one rule addressing requirements for qualified health plans and essential health benefits, which is in the last phase of the rulemaking process.

"It's been almost two years since reform was passed and we're still missing some of the most critical rules to implement the law," Justine Handelman, BCBSA vice president of legislative and regulatory policy, told FierceHealthPayer. "We recommended that all these rules be issued by January 2012 because it takes that long to contract with providers, set up IT and create new products."

BCBSA also wants HHS to increase the out-of-pocket deductible allowed on plans in the small-group market, which the reform law set at $2,000. That cap on deductibles will make it harder for insurers to develop "bronze plans," or plans with the lowest actuarial value allowed on exchanges.

Additionally, BCBSA said insurers should be able to charge older members higher premiums beyond the limits set in the reform law. Currently, insurers can't charge older members more than three times as much as their youngest members, but BCBSA wants the so-called age rating band to increase to a five-to-one ratio, the Wonkblog noted.

And Handelman wants HHS to drill down the details even further. For example, insurers need to know when the age band starts, when it ends and how often it should be adjusted. "These are critical issues that must be addressed," she said.

To learn more:
- read the Wonkblog article

Related Articles:
Reform to bring health M&A, open data
Obama's second term and healthcare reform: Just get it done
GOP governor backs off anti-reform stance
Healthcare prices, costs steady as jobs grow
Payers look to states for post-election reform progress