Pa. says no extensive planning on exchanges — without answers

By - Last modified: September 20, 2012 at 9:33 AM

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Pennsylvania has informed the U.S. Department of Health and Human Services that it will not perform extensive planning on health care exchanges and essential benefits until the department answers its questions.

Pennsylvania Insurance Commissioner Michael Consedine recounted the complexities of the issue in a statement to the Committee on Ways & Means last week.

"The final rule on 'exchange establishment,' one of the few regulations actually released, had approximately 100 references to 'future' or 'forthcoming' guidance or regulation. To date, I am unaware of any of those regulations being published. States are missing details regarding fundamental aspects of exchange operation, like application requirements, citizen and income verification and appeals processes," he said.

Consedine referenced an Aug. 23 letter to HHS in which he wrote, "Given the extent and nature of the questions that remain open, we have determined that at this time it would be imprudent for us to continue extensive planning efforts until we receive answers to these items.

"Therefore, Pennsylvania will not be expending any of its Level 1 Establishment grant funding until such a time when the information we require to make an informed decision is provided to us by your Department."

The letter concluded, "As we await your response, Pennsylvania will be continuing its work towards achieving meaningful and sustainable health care solutions in our state."

At the time of the statement, Consedine said, HHS had not responded to the letter.

Consedine is chairing a National Association of Insurance Commissioners group working to identify unaddressed issues with exchanges to help states to better understand the impact the operation of a federal exchange may have on their insurance markets. He said 22 states had signed up to participate.

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