Tag Archives: 1322

Remember the Tooth!

So I had to have a root canal a couple of weeks ago. Could explain why my energy level has been Less than Zero ™. But we press on with the next section of the PPACA.

The next big section of the PPACA again relates to the Exchanges. This larger section is called “State Flexibility Relating to Exchanges”.

Sec 1321 involves a lengthy, and perhaps somewhat repetitive, statement of what the requirements are for the new health insurance Exchanges. It states that the Secretary for HHS shall set up requirements for the Exchanges, how to offer qualified health plans (remember those!) through the Exchanges, the establishment of risk and reinsurance programs (which we haven’t discussed yet), and other appropriate requirements, such as whether you should wear a morning coat to a wedding after 10 a.m. (Maybe not that last one.)

The states are required to set up Exchanges by Jan 1, 2014, and if they are determined by Jan 1, 2013 to be unlikely to have these on time, then the Secretary can set them up for the states. This is enforceable (according to this law) by the Public Health Service Act.

Has it occurred to you by now, as it has to me, that this is a really dull Act?

Sec 1322 – Federal Program to Assist Establishment and Operation of Nonprofit, Member-Run Health Insurance Issuers. These are the CO-OP Health plans. Since presumably these plans won’t have giant piles of cash sitting around to help them be a part of the new mechanisms, the federal government will give them loans and grants to come into existence. They have to be actual non-profits, and not use these funds for propaganda or influencing legislation. Can we get more rules like this?

Lots of stuff about the boardmembers of the loan granting program– 15 members, unpaid except for travel expenses, terms expire in 2015.

The CO-Ops get to not pay taxes on the loans and they are subject to oversight by the GAO. Fun, thy name is the GAO.


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