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July Exchange Board Meeting: NPRM Released, ED Update, Strategic Visioning, Related Legislation

The California Health Benefit Exchange Board held their July monthly meeting in Sacramento on Friday. They announced that the Level 1 Establishment Grant application has been submitted to the federal government. A call is scheduled for next week to review the application.

Other announcements included the hiring of consultants for contracts and eligibility and enrollment, the creation of a questionnaire for potential IT vendors, and the establishment of two 15-person stakeholder workgroups on eligibility and enrollment (one for SHOP and one for the individual Exchange). In addition, the Board reviewed the proposed conflict of interest code.

NOTICE OF PROPOSED RULEMAKING
The Board plans to meet with other state agencies to come up with comments for the recently released NPRM on the Exchange. Comments are due to the feds by 9/28 and the Board will be accepting stakeholder input through August 18.

HIRING AN EXECUTIVE DIRECTOR
There are currently six qualified candidates for the ED position. In August, there will be a closed Board meeting to evaluate the two finalists. The goal is to hire an ED by end of August or early September.

STRATEGIC VISIONING
The California HealthCare Foundation (CHCF) shared four different visions for the Exchange and weighed the benefits and risks of each model. Each “vision” suggests a primary purpose the Exchange should serve. Some elements between models may overlap, while others are mutually exclusive:

1) Price Leader: Drive down premiums
2) Service Center: Create an enticing user experience
3) Change Agent: Incentivize delivery system reform
4) Public Partner: Integrate with public programs

PENDING LEGISLATION
The Board shared their views on pending California legislation that might affect the functionality of the Exchange. Below are summaries of the staff recommendations. To read the full report, click here.

AB 52 (Feuer) – Rate Approval: There is concern that rate regulation within the Exchange might delay premium rate negotiations, Exchange implementation and/or plan renewals.

AB 714 (Atkins) – California Health Benefit Exchange: Passing this bill now is premature. While this bill achieves the goal of notifying those eligible for the Exchange, there are too many uncertainties regarding eligibility and enrollment procedures to pass this bill now.

AB 792 (Bonilla) – California Health Benefit Exchange: Passing this bill now is premature. While this bill achieves the goal of notifying those eligible for the Exchange, there are too many uncertainties regarding eligibility and enrollment procedures to pass this bill now.

AB 1083 (Monning) – ACA Conformity: Federal law allows rate flexibility related to cigarette use and the use of prevention and wellness incentives. The bill restricts premium flexibility beyond the federal provisions. The Board passed a 3-0 motion to work with the author for flexibility or make into a 2-year bill.

AB 1296 (Bonilla) – Health Care Eligibility, Enrollment and Retention Act: Passing this bill now is premature. While this bill achieves the goal of notifying those eligible for the Exchange, there are too many uncertainties regarding eligibility and enrollment procedures to pass this bill now.

SB 703 (Hernandez)
– Basic Health Program: There is not enough information available to determine whether or not a Basic Health Program would be beneficial in California. There are concerns whether the removal of a large portion of individuals from the Exchange would have a negative impact. The Board passed motion 3-0 to oppose unless made into a 2-year bill.

To review all the materials from the meeting, click here.

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