Paiva Weed submits legislation on health benefits
Sen. M. Teresa Paiva Weed submitted on Jan. 28 legislation to establish a health benefit exchange in Rhode Island. Exchanges are intended to expand health care coverage, improve the quality of coverage, increase competition and transparency, and reduce costs.
A health insurance exchange is a marketplace – virtual or actual – through which small businesses and individuals can learn about their health insurance options and available subsidies. Similar to shopping online, individuals or those looking to purchase benefits for employees of a small business can visit the health benefit exchange website to purchase insurance or learn more about their options.
The Patient Protection and Affordable Care Act, part of the federal health care reform enacted in 2010, requires states to establish health benefit exchanges to be fully operational by 2014. The purpose is to make health care more accessible and to make the process of obtaining coverage easier.
The initial customers of the exchange would be individuals who purchase insurance on their own and small businesses. Exchanges will offer a variety of health plans, as well as information and educational services to help consumers understand their options.
The legislation submitted by Paiva Weed, who represents District 13 of Jamestown and Newport, and is president of the Senate, is known as the Rhode Island Health Benefit Exchange Act. It would establish the exchange in Rhode Island as a quasi-public agency to ensure that it is agile, flexible and responsive in order to be competitive.
Status as a quasi-public agency will also facilitate in obtaining federal funds for staff positions and contracts, while protecting the agency from bad state budget cycles. Further, the exchange must be capable of processing checks or subsidies to qualified businesses and individuals. A quasi-public agency may be more efficient at all of these tasks.
“This is the centerpiece of our health care reform implementation,” said Paiva Weed. “The exchange will create a health benefit marketplace that is fair, competitive, transparent and understandable to individuals and small businesses. It will also have the important job of getting federal subsidies to the people who need them.”
As established in the legislation, an 11-member executive board would govern the Rhode Island Health Benefit Exchange. The legislation explicitly prohibits board members from being employed by or affiliated with an insurer, insurance agency or broker, health care provider, health care facility or clinic.
The board would consist of the director of the Department of Administration, the Health Insurance commissioner and the secretary of the Executive Office of Health and Human Services. Also, eight public members would be appointed by the governor with the advice and consent of the Senate, with two members to represent consumer organizations and two members to represent small business.
The remaining appointments will provide expertise in a diverse range of health care areas, including individual health care coverage, small employer health care coverage, health benefits plan administration, health care finance, administering a public or private health care delivery system, and state employee health purchasing.
Paiva Weed noted that the Senate will work to establish the exchange this legislative session to make Rhode Island eligible for additional federal funds available to “early innovator” states.
“The exchange planning grant from the federal government provides Rhode Island with an opportunity to study our marketplace and impact of each decision we make on costs and the marketplace,” Paiva Weed said. “The experts on the exchange board will have the data and be able to analyze it, and the Assembly will then be able to make well informed decisions about issues such as, for example, whether large businesses should utilize the exchange.”