Some Colorado lawmakers are criticizing the HHS rules and regulations that will help to shape the health insurance exchanges that many states – including Colorado – are creating. HHS has been adamant that they have included as much flexibility as possible in the guidelines, in order to allow each state to implement its own exchange, designed to accommodate the needs of its people and businesses. But not everybody agrees (of course, when does that ever happen in the political/legal arena?)
One of the sticking points is the requirement that visitors to the exchange website have to be screened to see if they are eligible for Medicaid, CHIP, or the federal health insurance subsidy program that will begin in 2014. If they are eligible, the exchange website must complete the enrollment process. In addition, the health insurance exchange system should be “interoperable” (but not necessarily integrated) with other human services programs such as welfare and food stamps.
Some lawmakers in Colorado believe that this would result in a large increase in the use of public safety net programs, and would rather not have a “one stop shop” portal for assistance programs. But shouldn’t people who are eligible for those programs be able to enroll in them with as few barriers as possible? (if we want to change the eligibility guidelines, that’s a different argument entirely.) Nobody who qualifies for Medicaid or CHIP should be uninsured – period. High numbers of uninsured residents cost us all in the long run. It makes sense that the exchanges should serve as a portal to simplified enrollment in public health insurance programs. In terms of also enrolling people in other public programs (like food stamps, for example), I think it would be admirable if the exchanges could do that too, but perhaps it makes sense to focus on the health insurance aspect for now, given that the exchanges have just over two years to be up and running, and a lot of work to do between now and then.
The guidelines that HHS set forth were designed to make sure that state-specific exchanges meet basic minimum standards, while still allowing the states to accomplish many of those standards however they see fit. And although some would criticize HHS for being too restrictive, others have said that the agency did all they could to keep things as simple and flexible as possible.
Colorado State Rep Bob Gardner (R – Colorado Springs) is the vice-chairman of the legislative committee that oversees the Colorado health insurance exchange board. He’s opposed to what he sees as “restrictions” from HHS regarding the implementation of the exchanges, and said that “Colorado needs the maximum amount of flexibility to design this health benefit exchange for the good of the people of Colorado.” I’m curious though as to what specific “restrictions” he wants to do away with? It seems that having guidelines that hold the exchanges to a high standard of effectiveness (particularly in terms of getting as many people insured as quickly and simply as possible) is a good thing. A little accountability in the form of some federal oversight might just push us to create a better exchange than we would otherwise have.