All News

In continuing health reform implementation, the Department of Health and Human Services (HHS) issued a rule that defines which existing health insurance plans will be exempt from including certain consumer protections and what changes to these “grandfathered” plans would cause them to lose that status.

Health insurance exchanges, as envisioned in the Patient Protection and Affordable Care Act (ACA), have the potential to help deliver more affordable health insurance, greater cost transparency and expanded access. However, there are many steps along the path to well designed exchanges and hundreds, if not thousands, of technical decisions that state officials will need to make and remake if the state exchanges are to have a chance of meeting expectations. 

The Office of Consumer Information and Insurance Oversight (OCIIO) was created within the Department of Health and Human Services (HHS) by the Affordable Care Act (ACA) to implement and monitor many of the major reforms contained in the new health reform law. Among their many roles, the OCIIO is tasked with drafting rules which define when health insurance premium increases may be deemed “unreasonable”, managing the temporary high risk pool which will provide health insurance coverage to individuals who were previously uninsurable due to pre-existing conditions, and ensuring that insurance providers comply with the various consumer protections contained in ACA, such as the prohibition on insurance rescissions. This means that the OCIIO and its leaders, namely Jay Angoff, Steve Larsen, Karen Pollitz, and Harold Popper, will be largely responsible for the successful implementation of America’s health system reform. 

Congressional leaders on the House Ways and Means and Senate Finance committees have released the purported “tax extenders” bill (HR 4213), which among other things would raise doctors’ Medicare reimbursements 1% to 2% through 2013.