Secretary Sebelius Sends Letter to States
On July 10, 2012 Secretary Kathleen Sebelius issued a letter to governors addressing the Supreme Court opinion, the exchanges, the Medicaid expansion and the upcoming federal regional implementation forums.
More specifically, the letter reminded governors that funding to help establish exchanges is available, setting 10 deadlines for submitting exchange establishment grants between August 2012 through October 2014. It notes that at any point a state may seek federal funds to assist with the initial costs of an exchange, regardless of where the state may be in the process or who is administering it, i.e., the state, the federal government or a hybrid of both.
It also addresses the Court’s decision on the Medicaid expansion, stating that the ruling does not remove any provisions that allow an enhanced match for expansion populations, if a state chooses to expand eligibility. From 2014 through 2016, the federal government pays for 100 percent of the newly eligibles’ coverage, 95 percent in 2017, 94 percent in 2018, 93 percent in 2019, and 90 percent federal financing for 2020 and subsequent years.
Last, the letter provides locations for “Affordable Care Act Regional Implementation Forums,” which are intended for stakeholders and policymakers to ask questions and learn more about the law. These forums will be held in four cities: Washington D.C., Chicago, Denver and Atlanta during the first weeks in August.
With a Supreme Court decision behind us, some states are determining what their next step is after the ruling, while others are holding to their previously held positions on establishing—or not—component of the federal health law in their state. Stay tuned as the specifics become known from states and the federal Department of Health and Human Services.
Ballot Language Showdown in the Show-Me-State
In November, Missourians will vote on a ballot initiative to bar state officials from creating a health insurance exchange without legislative or voter approval. It would also prohibit state departments from taking federal money to prepare for the health insurance exchange required by PPACA. The measure was approved by the legislature during the 2012 session.
The ballot language released by Missouri Secretary of State Robin Carnahan on July 3 has incited a lawsuit from several legislative leaders.
Lieutenant Governor Peter Kinder, Senate President Pro Tem Rob Mayer, Senate Majority Leader Tom Dempsey, House Speaker Steven Tilley and House Majority Leader Tim Jones filed suit in Cole County Circuit Court this week arguing that the ballot language is misleading.
The language released was as follows:
“Shall Missouri law be amended to deny individuals, families, and small businesses the ability to access affordable health care plans through a state-based health benefit exchange unless authorized by statute, initiative or referendum or through an exchange operated by the federal government as required by the federal health care act?”
The lawsuit contends that the ballot measure is about whether the state will adopt a health insurance exchange, not about denying health coverage.
This is not the first time the legislature has asked citizens to vote on issues related to the Affordable Care Act. In August 2010, Missouri voters overwhelmingly passed Proposition C, The Missouri Health Care Freedom Act, which amended Missouri law to “deny the government authority to penalize citizens for refusing to purchase private health insurance or infringe upon the right to offer or accept direct payment for lawful healthcare services.”