State Working To Implement Affordable Care Act Requirements

Alaska is one of several states suing to overturn the Affordable Care Act- President Obama’s health care overhaul. But behind the scenes, state agencies are quietly working on implementing various requirements in the law. One of those requirements is an exchange, which will work kind of like Expedia, but for health insurance plans. While the state studies its options, a bill moving through the legislature would also establish an exchange.

Alaska is not anywhere close establishing a health insurance exchange. But the Parnell administration has taken the first step in that direction. Last month, the state hired a Boston consulting firm, Public Consulting Group to look at options for setting up an exchange. Josh Applebee is the state’s deputy director for Health Care Policy.

“The biggest problem I think is we don’t have enough information to decide are we going to do a state exchange, are we going to do a partnership with the federal government, are we going to let the federal government run the exchange themselves? If we do the state exchange, what does it look like? What kind of form is it going to take? How much is it going to cost? All of these questions need to be answered,” Applebee said.

The exchange will allow consumers to easily find and compare health insurance plans on line. Public Consulting Group is helping 13 other states decide how to implement an exchange. Applebee says the state will benefit from that experience, but the company will also have to take Alaska’s unique characteristics into account.

“Certainly we deliver health care farther than any other state and in different ways than any other state. So they can bring their experience with them, but they also need to apply that to whatever happens here in the state,” Applebee said.

Alaska is the only state that did not accept a $1 million planning grant from the federal government. And the state is paying Boston Consulting Group $200,000 for their work. A few states have exchanges in place and more than a dozen have made significant progress. Applebee says Alaska is benefiting from taking a slow approach.

“We’re learning from other state’s mistakes and we’re taking advantage of other state’s successes. And I think that’s an advantage we have in our timeline,” Applebee said.

If the state hasn’t made reasonable progress towards setting up an exchange by early next year, it may set the stage for the federal government to do it instead. That’s why Senator Hollis French- a Democrat from Anchorage, is hoping to convince other lawmakers to pass his bill establishing one.

“Once you realize you’re going to get an exchange imposed upon you from Washington, it only makes sense to try to create one that works for Alaskans,” French said.

Governor Parnell does not support French’s bill. And Senator French does not support the administration’s work.

“I think the Governor is making a mistake by circumventing the legislature and going without our input,” French said.

It’s unclear how much support French has among his colleagues in the legislature. He expects to bring his bill to the Senate floor for a vote soon. Senator Cathy Giessel – a Republican from Anchorage, will not vote for it. She agrees with the administration’s approach studying exchange options. Asked to speculate on how the bill will fare, she says the focus right now in Juneau is on just one thing: oil taxes.

“Wow, it’s really sucking the air out of the room, so I don’t know what chance this has of actually getting all the way through the process,” Giessel said.

But Senator French is optimistic. He says other aspects of the Affordable Care Act are controversial, but the health care exchange is not.

“This is really about just trying to find an affordable insurance policy for the citizens of the state, and most people can agree that’s a good thing. they may disagree about how you get there, but it’s a pretty rare person who doesn’t want to see more people covered by insurance,” French said.

The administration expects the consultant’s study and recommendations to be ready by the end of March or early April. But Applebee says the state will wait until the Supreme Court rules on the Affordable Care Act in June to decide how to move forward.

This story is part of a reporting partnership that includes APRN, NPR and Kaiser Health News.

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