Article by Cliff Finch. Published on Monday, July 04, 2011 EST. The countdown is on for Washington state to comply with the federal health care reform law. By summer of 2013 the state health insurance exchange must start signing up health insurance plans. Failure to be in position to do this by January 2013 will mean the federal government will take over the project.
The centerpiece of federal health care reform, the state health exchange, must be ready by mid-2013. Planning is now underway with a $23 million federal grant, and coordination with a Joint Legislative Select Committee will begin on July 26.
Molly Voris, charged with designing the state’s new health insurance exchange.
Special to Washington State Wire
Full implementation will require additional legislation, and Jonathan Seib, the Governor’s lead on health care, has the responsibility to develop the initial legislation that will go to the state Legislature in 2012. In the meantime, the state Health Care Authority will develop policy option briefs and work with the Joint Legislative Select Committee on Health Reform Implementation, which will hold its first interim meeting on July 26 in Olympia.
Even a bare minimum exchange will be a complex organization with a high-tech information system that must make it easy for small employers and individuals to understand and purchase health insurance. In addition, the exchange must determine eligibility for subsidies, certify qualified health plans, and direct eligible individuals into Medicaid and other public programs.
Effective December 22 of last year the Health Care Authority placed responsibility for the organizational design of this enterprise in the hands of a new face in Washington state, Molly Voris. The warm smile and pixie-esque appearance of this Indiana native is disarming, but the strong eyes and measured voice leave no question that you are talking with an experienced health care professional. She has a Masters’ Degree in Public Health from George Washington University and worked with the Kaiser Family Foundation and National Governors’ Association before accepting the new position.
Voris’ first challenge is to manage a new federal grant of $23 million to fund the process. About $19 million of this will go into designing of the information system. Among other things, the remainder will fund contractors and staff who will develop nine policy briefs that will examine the key issue options that must be resolved to implement the exchange.
There has been some controversy over the selection of the contractors in the federal grant proposal, but Voris has reassured many with her commitment to an open process. For each policy brief she will develop a draft project plan which will be circulated to key stakeholders and reviewed by a technical advisory committee before being finalized and given to the contractor. The process will be repeated with the draft work products. The first policy-brief draft project plan on Basic Health Plan options should be out in another week.
She will also be holding public meetings on the state exchange around the state, in coordination with the Joint Legislative Select Committee.
Even if legislation does not pass in 2012, planning will continue. Under legislation passed this year, Senate Bill 5445 (Chapter 317, Laws of 2011), a public-private organization called the Washington Health Benefit Exchange will take over the responsibilities on March 15, 2012. However, most expect that Molly Voris will shift over and join the Exchange staff.
Nonetheless, at some point implementation legislation will be required. To meet the 2013 timeline several planning decisions will have to be made in 2012. The hope from state planners is that the Legislature will step up to the task and provide the guidance sooner rather than later. However, many legislators see no need for a state-government-sponsored exchange.
Policy decisions will especially be required on the rules that will govern health insurance plans inside and outside the Exchange. The state must draft criteria that must be met by the plans offered by the exchange. Whether the Basic Health Plan is to be continued will also greatly affect the design, as will the payment mechanism for subsidies and any involvement in premiums. Some policy decisions could be put off to 2013.
In what time she has left over, Voris’ clear priority is family. Her limited first-year state-employee vacation time will go for family visits in Indiana and here in Washington state with her husband’s family. Top priority, she says, is their three-year-old daughter.
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