Health Reform Coordinating Council

 

 

Thanks to the new federal health care law (Patients Protection and Affordable Care Act), Maryland has the opportunity to design and implement a health insurance marketplace that will allow individuals and small businesses get a better deal on quality, affordable health insurance.

The new competitive market place, often referred to as an “Exchange,” will simply be a ‘transparent marketplace’ where people can shop for federally funded insurance subsidies, competitive insurance premiums, and quality, patient-centered care plans.

The Maryland HB 443 aims to reduce the number of uninsured Marylanders; and to provide Marylanders with competitive high-quality, affordable private health plans.

The Maryland Health Benefit Exchange Act of 2012 intends to provide a framework for the development of a highly effective, efficient, and accountable Health Benefit Exchange, and a successful launching of the Maryland Exchange by January 1, 2014. HB 443 will:

1. Make health care more affordable by allowing competition

This bill gives the Exchange power to require insurers to offer required health benefit plans at affordable prices. To participate in the Exchange, insurers will have to adhere to strict rules and standards.

2. Allow consumer choice

The Exchange will be designed in a manner that will allow consumers to have more control, quality choices, and better protections when buying insurance. There will be trained individuals (navigators) who will educate consumers on available choices, assist them in enrollment, renewal, and disenrollment into qualified health or dental plans, determine their eligibility for any tax credits, and assist them to get any grievances resolved.

3. Assure quality health care

The bill offers some guidelines on requirements for certification of health benefit plans and dental plans. The bill is encouraging formation of a taskforce of public and stakeholder to develop detailed guidelines on what is to be included in Maryland’s Essential Health Benefit (EHB) Package. The EHB will promote continuity of care, health equity, prohibit discrimination, and ensure provision of preventative and other general services to all Marylanders.

4. Assure transparency

The law will require insurers to report to the U.S. Department of Health and Human Services (HHS) and to their enrollees’ information on how the health plans designs, structures, and reimbursement structures are improving patient safety and health in Maryland. In addition; Insurers will be required to submit detailed quarterly reports on plan quality, cost of coverage, and enrollee satisfaction to HHS and the State insurance commissioner. The Exchange is expected to abide by a set rules, regulations, and deadlines. This will allow for fraud, waste, and abuse detection, and hopefully encourage transparency and innovation. Insurance companies will be responsible for providing good service to consumers.

To learn more about the bill and the Health Benefit Exchange in Maryland, please refer to:

• HOUSE BILL 443
• Essential Health Benefits
• Recommendations for a Successful Maryland Health Benefit Exchange
• The Maryland Health Benefit Exchange

Public Meetings on  Recommendations

The federal Affordable Care Act is law, national health care reform is a reality, and implementation by the states has begun.

Governor Martin O’Malley established the Maryland Health Care Reform Coordinating Council to recommend policy and strategies for implementing federal health care reform. This council is co-chaired by Lt. Governor Anthony Brown and Secretary John Colmers.

The Health Care for All! Coalition has been very active in this process. Members of our board of directors, coalition partners, staff and volunteers have participated in all meetings thus far and submitted formal comment to each workgroup.

The Council’s final recommendations, address:
• The ways and means to enroll people who will be newly eligible for health insurance
• Assurances for maintaining a healthcare safety net
• Increases to the primary healthcare workforce
• Development of cost-efficient, quality payment systems
• Means and methods to distribute health care information to the public

Public input on these recommendations is very important.

Special thanks goes out to those of you who participated in the regional public forums for the Health Reform Coordinating Council. All meetings were open to all members of the public. Participants were given opportunity to make brief comments which should specifically address only the Council’s draft recommendations. Anyone who was not unable to attend, or would like to offer broader comment on health reform beyond the Council’s draft recommendations is invited to send written comments via the Council’s website.  We’re happy to help you draft comments or fill you in on any meetings you may have missed.

Copies of our coalition’s official comments to each workgroup may be downloaded below.

Official Comments to the Exchange Workgroup

Official Comments to the Delivery System Workgroup

Official Comments to the Workforce Development Workgroup

Official Comments to the Entry to Coverage Workgroup

Official Comments to the Education and Outreach Workgroup

Official Comments to the Safety Net Programs and Special Populations Workgroup