Oversight for insurance exchange amended, advanced

Senators gave first-round approval April 24 to a bill intended to create state-based oversight for Nebraska’s health insurance exchange.

Under the federal Patient Protection and Affordable Care Act, Nebraska is required to have an operational health insurance exchange by Jan. 1, 2014. Nebraska will have a federally facilitated exchange.

LB384, introduced by Omaha Sen. Jeremy Nordquist, would create the Nebraska Exchange Stakeholder Commission. Nordquist said the bill would provide the state a group of stakeholders willing to work with the federal government to ensure a smooth transition to the new system.

“I believe Nebraskans deserve a say in the creation of the health insurance marketplace,” he said.

Under the bill, the commission would:
• work with state and federal agencies and policymakers to provide oversight and recommendations regarding implementation and operation of the exchange;
• create technical and advisory groups as needed to discuss issues regarding the exchange and to make recommendations to the commission, state or federal agencies and the Legislature;
• assist the exchange in meeting the stakeholder consultation requirements as provided in federal regulations; and
• identify challenges and problems in the implementation and operation of the exchange and prepare recommendations to alleviate the problems identified.

The commission would report to the Legislature by Dec. 1, 2013.

As introduced, the commission’s 12 members would include:
• three health care consumers, one from each congressional district;
• one small business representative;
• two health care providers;
• one health insurance agent;
• one health insurance carrier representative;
• one member of the Rural Health Advisory Commission; and
• three nonvoting, ex officio representatives of the state departments of insurance and health and human services.

Members – appointed by the governor and approved by the Legislature – would serve four-year terms.

A Banking, Commerce and Insurance Committee amendment, adopted 26-0, removed the requirement that consumers represent each congressional district and that one member represent the Rural Health Advisory Commission.

Instead, the amended bill would require four members to represent the interests of consumers, with at least one representing rural consumers who will access health insurance in the exchange.

The amendment also would sunset the commission July 1, 2017.

Nordquist offered an amendment to the committee amendment that removed the state Department of Health and Human Services (DHHS) director of Children and Family Services from the commission.

He said the director originally had been included because the division currently is responsible for Medicaid eligibility determinations. However, a pending DHHS reorganization will move that responsibility to the Medicaid division, he said.

After adopting the Nordquist amendment 26-0, senators advanced LB384 to select file on a 28-0 vote.