After looking over both versions of Exchange legislation, the Senate’s and the Governor’s, it is clear that the Gov.’s bill is the way to go. However, it’s not perfect.
The ship is sailing on this legislative session, and if New York is going to qualify for increased federal funding, and be ready to have an insurance exchange set up and running by 2014, we need to pass a bill NOW. And not just any bill – a GOOD bill.
Governor Cuomo’s version comes darned near close. For the exchange to work for consumers and small businesses, the following priorities must be included in this year’s law:
1) The Exchange board must be bound by strong and explicit conflict of interest provisions. Neither bill has explicit conflict of interest provisions. New York should include a specific prohibition, as found in the California exchange legislation, on board membership for any and all representatives who stand to gain financially from the business of the exchange, including carriers, agents, brokers, and providers. Defaulting to current Public Authority and Public Officers Laws leave open the possibility that someone with a financial interest in the operation of the exchange may obtain a seat on the Governing Board. Other states have recognized and addressed this issue in their exchange statutes and likewise New York should ADOPT an anti-conflicts provision.
2) The Exchange must have the authority to be an “active purchaser.” Governor Cuomo’s proposal is very consumer and small business-friendly by giving the new exchange the authority to be an “active purchaser,” whereas the Senate bill prohibits any action by the Exchange Board on active purchasing (or selective contracting). Active purchasing allows the exchange to use purchasing power to bargain for better value and lower prices on behalf of consumers and small businesses. This is not a new regulatory function; rather, it empowers the exchange to fulfill the promise of federal health reform and will ensure that New Yorkers can access high quality and affordable insurance. Without this authority, the exchange will be a confusing and overwhelming “clearinghouse” for any and all insurance plans that meet the minimum federal requirements, regardless of whether they meet people’s needs. SUPPORT Governor Cuomo’s bill which grants the exchange the authority to bargain on behalf of consumers and small businesses.
3) Products in the Exchange must be standardized so consumers and small businesses can make simple “apples-to-apples” comparisons. Governor Cuomo’s proposal permits the exchange to standardize policies beyond the minimum federal requirements; the Senate bill is silent on the issue. Insurance products, information, and benefits should be standardized in a simple way so that people and small business owners can compare options and make informed choices. SUPPORT Governor Cuomo’s provision to empower the exchange to standardize plan selection ensuring that consumers have a simple, straight-forward choice of plans.
4) The Exchange must include health equity provisions. Legislation should require the composition of the Board and the Advisory Committee to explicitly reflect the racial, ethnic, gender and other types of diversity across New York. Second, it should require the exchange to study methods for addressing health disparities, including through the provision of coverage. In a diverse state like New York, the Legislature should ADOPT health equity provisions in the exchange law.
It’s time to make this thing right for once and for all – FULL STEAM AHEAD! Anybody who will be in the Albany region tomorrow is invited to stop by the capitol for to join HCFANY for a press event and legislative visits on the exchange bills. Click here for details!