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CCH® BENEFITS — 10/20/11

State Health Care Reform Update

from Spencer’s Benefits Reports: For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. With the passage of federal health care reform, states will have increasing responsibilities in regard to employer-provided health insurance benefits. Spencer’s Benefits Reports continues to provide regular updates about state health care reform.

Health insurance exchange grants. The Department of Health and Human Services (HHS) has awarded $185 million in grants to 13 states and the District of Columbia to help establish the insurance exchanges created by the Patient Protection and Affordable Care Act (ACA). The grants are available to states that have taken some action to set up an exchange, but the state did not necessarily have to pass a state law to create the new marketplace. The single largest establishment grant—more than $38 million—went to California, the first state to pass an exchange law. Other states include Connecticut, Illinois, Kentucky, Maryland, Minnesota, Mississippi, Missouri, Nevada, New York, North Carolina, Oregon, and West Virginia. For more information, visit http://www.healthcare.gov/news/factsheets/exchanges05232011a.html.

Arizona. Federal health officials have extended Arizona’s current Medicaid program beyond October 8, when it was due to expire, to allow more time to consider a state plan with proposed cuts. Two key program cuts already have won federal approval, and more than 100,000 Arizonans are expected to lose health coverage in the first year as a result. The remaining cuts affect thousands more, including an estimated 30,000 low-income parents who are expected to lose coverage by next July. For more information, visit http://www.azahcccs.gov/.

California. A bill that would allow California officials to regulate health insurance rates for millions of consumers has died in the state legislature after complaints from insurers, health care providers and other groups. Assemblyman Mike Feuer has pulled the measure, AB52, because he could not muster a majority of votes in the state Senate. The new rate reviews under the ACA, which are supposed to target any premium hikes higher than 10%, went into effect September 1. For more information, visit http://insurance.ca.gov/.

Illinois. Governor Pat Quinn has signed H.B. 224 into law, which helps bring Illinois’ health insurance polices more in line with the ACA. Under previous Illinois law, health insurance companies were required to establish and maintain external review procedures that allow a consumer to appeal the denial of certain health insurance claims to independent review organizations. The ACA mandates that all state external review laws must meet certain minimum consumer protections, including the time frame in which a decision must be reached or who can assign an independent review organization to review an appeal. H.B. 224 amends the state’s Health Carrier External Review Act to meet the minimum federal requirements. It also extends Illinois’ external review rights to consumers whose coverage has been rescinded or who have been denied a benefit due to a preexisting health condition. For more information, visit http://insurance.illinois.gov/.

Ohio. The Ohio Supreme Court has ruled that a proposed amendment to the state constitution that would block implementation of the ACA can appear on the ballot this November. The proposed constitutional amendment would block the ACA’s individual mandate to buy insurance. The court, in a 7-0 opinion, denied an attempt to kill the amendment from the group ProgressOhio. The amendment is known as Issue 3, and would allow Ohio residents to opt out of the requirement in the health care law that all Americans have insurance. For more information, visit http://www.sconet.state.oh.us/.

Vermont. Governor Peter Shumlin has appointed five individuals to the newly created Green Mountain Care Board, which will lead the state toward a more unified health care system. The following individuals have been appointed: Anya Rader Wallack, chairwoman; Al Gobeille of Shelburne; Allan Ramsay of Essex Junction; Con Hogan of Plainfield; and Karen Hein of Jacksonville. The panel, which began work on October 1, will focus first on changing the payment system for medical care. For more information, visit http://www.greenmountaincare.org/.

Washington. The Seattle City Council has passed an ordinance that requires employers to provide paid time off to employees who work in Seattle. The ordinance will go into effect on Sept. 1, 2012. The ordinance applies to all employers with at least five employees. Employees are covered if they work in Seattle and perform more than 240 hours of work per calendar year. Starting Sept. 1, 2012, employees will begin accruing at least one hour of paid time off for every 40 hours worked. Depending on employer size, employers can limit employees to using up to 72 hours of accrued paid time off in a calendar year. If a Seattle employer already had a paid time off program in place that provides at least as much leave as the ordinance requires, employers need not provide additional time off. For more information, visit http://www.seattle.gov/council/.

For more information on this and related topics, consult the CCH Pension Plan Guide, CCH Employee Benefits Management, and Spencer's Benefits Reports.

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