By Richard Asinof
(Updated, July 15, 2:30 p.m.)
PROVIDENCE – Following its meeting on July 18, the Executive Committee of the R.I. Healthcare Reform Commission will formulate a recommendation on the wording and scope of an executive order to create a R.I. Health Insurance Benefits Exchange.
The recommendation will then be sent to Gov. Lincoln D. Chafee; the committee has not yet set a date for when it will send its recommendation to the governor.
The decision to create the exchange by executive order follows the R.I. General Assembly’s failure during its session to enact enabling legislation for such an exchange, according to a spokeswoman in Lt. Gov. Elizabeth Roberts’ office. At stake are about $15 million in federal funds, the deadline for which requires the structure of a state’s health insurance exchange to be in place by the end of August.
The failure to enact the legislation centered on an amendment offered by Senate President M. Teresa Paiva Weed that restricted the ability of women to use private insurance to pay for abortion, language more restrictive than state or federal law. The amendment was included in the bill passed by the Senate.
There are several options now under consideration for how to structure the health insurance exchange, according to a presentation shared at a public stakeholder meeting of the Healthcare Reform Commission on July 8.
One would place it under the jurisdiction of the R.I. Department of Health, another would create it as a quasi-public authority, and a third would place it under a nonprofit corporation. A fourth option, brought up during the stakeholders’ meeting, was to locate it under the Office of the Health Insurance Commissioner.
Language for the executive order has been proposed by HealthRIght, an independent group supporting health care reform in the state, which met on July 12, with Stephen R. Hourahan, senior adviser to Chafee.
From HealthRIght’s perspective, there is a need to centralize authority for health care regulation into a single coordinated entity, according to Ted Almon, president and CEO of The Clafin Co. in Warwick and member of the executive committee of HealthRIght.
Almon, speaking for just himself and a group of small businesses concerned with health care, the Summit Business Group Healthcare Subcommittee, believes “the Office of the Health Insurance Commissioner to be the best platform for that effort.” The problem with locating it at the R.I. Department of Health, he continued, was that the agency was “shackled with numerous unfunded mandates, and they are seriously understaffed at present.”
“We also need to bolster the image of the Office of the Health Insurance Commissioner as the only element of the Chafee administration that currently has both the policy expertise but also the courage to control costs,” Almon said.
HealthRIght itself has not taken a specific position about exactly where in state government a health insurance exchange should be located. In a letter sent to the Executive Committee of the R.I. Healthcare Reform Commission, the group said: “While our members tend to support … establishing a new division within an existing state department, we urge you to chose a governance model based on its ability to implement the mission of the exchange in the most efficient and transparent manner.”