Nebraska's top insurance regulator says HHS HIX rules are still hard to intrepret, and the state's governor wants federally-funded HSAs. In Vermont, the Chamber of Commerce has launched a private HIX.
Nebraska insurance commissioner says HHS regs still murky
Nebraska's top insurance regulator told a mid-October stakeholder briefing that it's not clear to him whether Nebraska should pursue its own exchange, co-run one with the federal government or have a federally-facilitated exchange.
Bruce Ramge, the Nebraska Insurance Department director, is likely to be charged with drafting a HIX, if the state creates one. Echoing some other state insurance regulators, Ramge said he was still confused about some of the rules laid out in guidelines by the Department of Health and Human Services' Center for Consumer Information and Insurance Oversight, as the Nebraska News Service wrote.
Nebraska Gov. Dave Heineman has decided to wait for the presidential election results before implementing an HIX, but he has been open to it, and he recently submitted an essential health benefits benchmark he says is compliant with the Affordable Care Act. The plan has a $4,000 deductible for individuals and costs about 28 percent less than the state's most popular small group plan offered by Blue Cross and Blue Shield of Nebraska.
Heineman, a Republican, also suggested in his EHB submission that the federal government could help fund health savings accounts for people who buy high deductible plans as a way to lower premiums across a market, the Nebraska World Herald News reported.
[See also: Some states to partner with HHS on HIXs]
Vermont Chamber launches a private HIX
Amid Vermont's multi-phase bid to create a publicly-financed statewide health system by 2017, the Vermont Chamber of Commerce has opened an HIX to its members, offering defined contribution plans.
Betsy Bishop, president of the Vermont Chamber of Commerce, said the "Chamber Preferred" exchange is "a novel approach to the complex challenge of containing employee benefit costs."
Noting that after 2014 Vermont small businesses will be required to buy health insurance through the state HIX, Bishop said in a media release that the exchange is "an optimal solution to help these companies attract and retain talent by delivering a compelling selection of crucial insurance benefits not offered through a state exchange, such as disability, life and dental."
The exchange is now open to any size business and is based on the exchange technology of benefits firm Liazon, with consulting from Digital Insurance's Digital Benefit Advisors.
It's not clear how if at all this may affect Vermont's plans for a highly regulated HIX, estimated to have 80,000 people in its first year. Seeking input on proposed HIX consumer assistance and information programs, the Department of Vermont Health Access recently reached out to brokers, business groups and nonprofits with a survey. The agency wants to have a long-term state-funded "navigator program" and a federally-funded consumer program for people first buying insurance in the HIX, as VTDigger.org wrote.