It's debatable if the fiduciary standard is 'higher' than suitability. But the better question might be, who's holding the bar?
Nov. 15--Democratic state lawmakers are urging Gov. Tom Corbett to end delays in setting up a state-based health insurance exchange, a key provision of federal health care reform.
The Corbett administration has until Friday to let the Department of Health and Human Services know its plans for the virtual marketplace, where an estimated 2 million Pennsylvanians will be able to buy health insurance starting in 2014.
"We believe that it is time for the Commonwealth to follow the example of the 13 states that have already passed exchange legislation and begun the implementation process," state Rep. Tony DeLuca, D-Penn Hills, wrote to Corbett on Tuesday. The letter also was signed by nine Democratic members of the House Insurance Committee, of which DeLuca also is a member.
"This is no longer an issue with a political solution; the time has come for Democrats and Republicans to work together to implement the federal law in a way that benefits the citizens of Pennsylvania," the letter states.
Rep. Dan Frankel, D-Squirrel Hill, sent a letter to Corbett on Wednesday asking for a decision.
Corbett, who opposed the health care reform law, has not made a final decision, an administration spokeswoman, Christine Cronkright, said. But he plans to "let the public know" once a decision is made, Cronkright said.
"We continue to have questions about how a state-operated exchange would function," she said.
State Insurance Commissioner Michael Consedine in August sent a letter to Health and Human Services Secretary Kathleen Sebelius listing 26 questions about various parts of the law, including how much it might cost if the federal government ends up running an exchange in Pennsylvania.
Cronkright said Sebelius has not answered the questions. "We prefer to make an informed decision" on the exchange, she said.
In addition to setting up and running its own exchange, the state has two other options. It could partner with the federal government on an exchange in which some aspects are run by the state, or it could let Health and Human Services run the whole thing.
"Regardless of who runs the exchange, Pennsylvania individuals, families and small businesses will finally have access to quality, affordable coverage in a health insurance marketplace starting Jan. 1, 2014," said Antoinette Kraus, project director for the Pennsylvania Health Access Network, a statewide coalition of groups that has advocated for a state-run exchange.
"At this point it is highly unlikely that Pennsylvania will move forward with a completely state-run exchange," Kraus said.
Pennsylvania is one of 19 states that haven't issued a decision, according to the Kaiser Family Foundation. Twelve states have so far said they will not run their own exchange. The remaining 19 will either run their own or partner with the federal government.
"Governors should join the growing chorus in sending a strong message to Washington that their states will not implement these flawed health insurance exchanges," Nicole Kaeding, state policy manager for Americans for Prosperity, said.
"Exchanges raise prices on consumers and increase taxes on hard-working families," she said.
Consedine said last month that the state wouldn't have time to establish a state-run exchange by Jan. 1, 2014, because its planning work stalled on the unanswered questions.
Sebelius on Nov. 9 wrote to governors, including Corbett, who haven't announced their decisions and extended a deadline for submitting plans for state-run and partnership exchanges. States were to have submitted plans by Friday, but the deadline for state-run exchanges was pushed back to Dec. 14 and to Feb. 15 for partnership exchanges.
Rosanne Placey, spokeswoman for the Insurance Department, said the department was reviewing the extension.
"The new extended deadlines appear to indicate flexibility in the overall timeline, which we see as a positive development," she said.
Diane Lataille, an Allegheny General Hospital registered nurse and a vice president with SEIU Healthcare Pennsylvania union, called for Pennsylvania to have its own exchange.
"Gov. Corbett should have acted sooner to embrace and develop a state exchange program for Pennsylvania," Lataille said. "We urge him to act immediately while there is still time for us to have local input and control."
Alex Nixon is a staff writer for Trib Total Media. He can be reached at 412-320-7928 or [email protected].
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