- Policy & Research
- About KHI
Originally published Sept. 5, 2012 at 5:58 p.m., updated Sept. 6, 2012 at 9:17 a.m.
TOPEKA An executive with Blue Cross Blue Shield of Kansas today urged state insurance regulators to consider recommending one of his company's plans as the benchmark for basic benefits to be offered through a new, digital health insurance marketplace.
"Our depth of experience, length of experience, breadth of our network and breadth of our consumer base show that our product — and the benefits that are in them developed over the course of the 70 years we've been in the marketplace — are the ones that Kansans have chosen. And so given all the data before you…the choice, I think, is clear that the Blue Cross comprehensive plan is the recommendation to make," said Matt All, the company's top attorney and vice president of public policy.
Blue Cross of Kansas is a non-profit company that is the state's largest health insurer. It covers more than 900,000 Kansans and operates in all but two of the state's 105 counties, All said.
Governors can choose
All was one of about a dozen speakers who testified Wednesday before Kansas Insurance Commissioner Sandy Praeger at a public hearing held to collect input on what basic or "essential" benefits should be included in the plans marketed through the insurance exchange slated to be operational in 2014 as part of the 2010 federal health reform law.
Federal officials have left it to governors to choose which plan will be the benchmark in each state and have said they want those choices made by the end of the month. In the event a governor does not make a selection, the benefits will be decided by federal health officials.
Insurance department officials are preparing a recommendation for consideration by Gov. Sam Brownback and are expected to submit to him in about a week their report with at least a couple of options outlined in it.
Brownback, among the Republican opponents of what is commonly known as Obamacare, has said he will have no part in implementing the law until after the November presidential election. GOP presidential hopeful Mitt Romney has vowed to repeal the law as a first order of business, if elected.
Spokesmen for the governor reiterated his stance on Wednesday.
"As the governor has said on multiple occasions, all decisions relating to the implementation of Obamacare will be made after the November elections," said chief spokesperson Sherriene Jones-Sontag.
Praeger and others have said they prefer a model selected by Kansans rather than one decided in Washington.
Sooner is better
Policymakers on Wednesday also were urged to settle quickly on a benchmark plan so that insurance companies can begin implementing the new policies.
"We believe the sooner the decision is made the better so that carriers can implement the plan and we would ask that that plan be in place through 2015," said Jarrod Forbes, vice president of government relations for UnitedHealthcare, a major firm that recently inked a contract with the Brownback administration to provide managed care services through the state's Medicaid program.
More than 100 people attended the public hearing Wednesday. About a dozen offered comments and several more gave written testimony.
Several of those who spoke urged selection of a benchmark plan that would provide comprehensive dental and vision care for children.
None of the nine plans under consideration by the insurance department would meet all the standards for pediatric care that the Affordable Care Act requires, so if one of them is chosen by Brownback it would need to be supplemented, according to an analysis prepared for regulators by the consultancy Milliman, Inc.
"One of the hallmarks of the Affordable Care Act is that...all the children in our country will be guaranteed dental coverage for the first time in our nation's history," said Tanya Dorf Brunner of the advocacy group Oral Health Kansas.
Dr. Pam Shaw, a professor at the University of Kansas Medical Center, spoke on behalf of the Kansas chapter of the American Academy of Pediatrics.
She urged selection of a benchmark plan that would provide a broad range of preventive services for children, including dental and mental health care "without cost sharing to the family."
Shaw said she was the mother of an autistic child and that the benchmark plan should include coverage for autism services. The benchmark also should include a broad range of preventive services for children, including dental and mental health care "without cost sharing to the family."
"We have before us a golden opportunity to do something that will benefit the almost 800,000 children in our state and do it for very little cost," she said. "It's important to invest in our children now and especially in their early formative years."
Eric Stafford spoke on behalf of the Kansas Chamber and asked that the benchmark not be too rich in benefits because that would drive up the cost of premiums and likely push many employers from providing coverage.
"If we want to maintain the employer-based (health insurance) model, we have to be very cautious about how we regulate insurance plans in our state to assure that businesses can afford to do so for their employees," Stafford said.
His concern was echoed by at least a couple of speakers.
Sheldon Weisgrau of the Health Reform Resource Project said it was clear that the benchmark plan would need to balance costs with benefits. But he said Congress had included the essential benefits provisions in the law as a safeguard to assure that consumers were "protected from products that offer very limited coverage and value."
He said regulators should emphasize clear choices for consumers.
"The health insurance market would not currently be characterized as consumer friendly," he said. "There's excessive small print and the near impossibility of making apples-to-apples comparisons."
Weisgrau said policymakers should assure that plans offered on the exchange are described in equal terms so consumers are better equipped to comparison shop.
"Some standardization would be appropriate," he said.
Praeger told the crowd of about 100 people that various factors in addition to the benefits ultimately would determine the costs of the plans offered through the exchange, including the administrative costs of the insurance companies offering the plans.
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.