With Obama win, time is of the essence for payers

Payers can expect to see clearer regulations by week's end

President Obama's re-election to the White House will accelerate plans to comply with the health reform law.

Tuesday's presidential win will likely unleash a "torrent of rules that have been withheld until after the election," David Merrit, managing director of intelligence business firm Leavitt Partners told FierceHealthPayer.

For example, payers can expect to see regulations for federal exchanges, guaranteed issue, rating limitations and community rating, maybe even by the end of this week, Merritt noted.

Such information would be welcome news for health insurers. In fact, Independence Blue Cross President and CEO Daniel Hilferty said one of the biggest barriers to being ready for reform has been "the need for clear guidance from the U.S. Department of Health & Human Services," he told FierceHealthPayer.

The much-needed guidance will clarify how the Affordable Care Act requires insurers to design their plans, set rates, as well as how to connect to the new exchanges, Hilferty noted.

While most insurers have been moving forward with implementing reform provisions as best they can, "speed and timing is of the essence," Merrit noted. With the law taking full effect in 2014, insurers need to "start working on it yesterday," he added.

Insurers, including Independence Blue Cross, may be feeling the time crunch. ACA compliance means getting plans ready for health insurance exchanges that go live Oct. 1, 2013, Hilferty said.

Network Health, a Tufts Health Plan affiliate, is busy preparing for the population shifts and market changes that will take place in 2014, all while ensuring the least possible disruption in services to its members, Christina Severin, Network Health president, told FierceHealthPayer.

To fully implement reform provisions, health insurers must collaborate with state policymakers, since many of the provisions, such as Medicaid expansion and insurance exchanges, will be executed at the state level.  

With that in mind, Independence Blue Cross will keep working with policymakers to find bipartisan solutions to improve care and make it more affordable, according to Hilferty.

That work might not be easy. This election season, Republicans secured 30 governorships, forcing a number of red state governors to implement a law they most likely oppose, Merrit noted.

Until the Obama administration releases more detailed guidance, the law still leaves something to be desired.

"We do believe there are some key issues that need to be addressed, including the premium tax, essential benefits and age-rating restrictions," America's Health Insurance Plans spokesperson Robert Zirkelbach told FierceHealthPayer.

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