As part of the Affordable Care Act, states have the option to set up a Health Benefits Exchange in order to provide more affordable care for their citizens, or they can rely on the federal government to set one up for them. Virginia has decided to set up its own Health Benefits Exchange and must have the legislation approved during the next legislative session (ending in April 2012).
The Commerce and Labor committees of both legislative houses will meet November 15 in Richmond for a joint briefing by the Secretary of Health and Human Resources, Bill Hazel, on setting up a Health Benefits Exchange. Hazel runs the Virginia Health Reform Initiative (VHRI)—an advisory panel put in place by the governor to advise on implementing the health care law.
Virginia Organizing has been working on health care law implementation, including testifying at VHRI meetings, surveying small business owners and holding public forums on the health care law and its implementation. We will continue to fight for a Health Benefits Exchange that provides the lowest rates and the highest quality product for Virginia’s consumers. We are currently waiting for the VHRI final report outlining their recommendations.
The Virginia Main Street Alliance (VMSA), a small business project of Virginia Organizing, is also watching the implementation process closely. The VMSA is concerned about whether the Health Benefits Exchange will allow small businesses into the “buyers club” which is a large pool that will be allowed to use its buying power to get better rates.
The Health Benefits Exchange should have over 100,000 covered employees. With this many participants, we should be able to negotiate for lower rates for Virginia’s small businesses. The Virginia Main Street Alliance has HYPERLINK "http://www.virginia-organizing.org/content/making-health-care-work-virginias-small-businesses-preliminary-findings-2011-virginia-smal-0" surveyedmore than 400 Virginia small businesses about whether the Health Benefit Exchange should be allowed to use its buying power to get lower rates. Over 70 percent of the small businesses surveyed support using this buying power to negotiate for lower rates.
The type of Health Benefits Exchange that Virginia ends up with in April 2012 will be determined by whether the Virginia General Assembly is protecting the interests of Virginia’s consumers and small business owners, or the big insurance companies.
Virginia Organizing strongly supports the following priorities for Virginia’s Health Benefits Exchange:
-Governance: We want to draw a strong line on Conflict of Interest. We believe anyone with a current financial conflict of interest with the insurance industry should NOT be a voting member of the Exchange Board. We will have a back up position, as well that focuses on consumer representation should this fail.
-Quasi-Governmental Structure: We strongly feel that the Exchange Board should be structured as a quasi-governmental agency with Board members appointed by the Governor.
-Active Purchasing: We believe the Exchange should be able to negotiate the lowest rates and have the flexibility to react to, respond to, and monitor the market and plans within the market. We want to ensure the greatest efficiency through matching quality of care and cost effectiveness. The Exchange should be proactive.
-Level Playing Field: We believe the rules and offerings should be the same inside and outside of the Exchange to prevent adverse selection.