Some states won't enforce reform law, so Feds must

With multiple health reform deadlines looming, some states are declaring they won't enforce the law, deferring instead to the U.S. Department of Health & Human Services to guarantee insurers in their state comply with the provisions.

So far, five states--Florida, Missouri, Oklahoma, Texas and Wyoming--already have notified HHS that they either can't or won't police insurers to uphold the reform provisions, Politico reported.

Florida, for example, won't penalize insurers for violating new consumer protections but will report those insurers to HHS to take further action. Other state officials say their legislatures haven't granted them the authority to oversee reform requirements. In Wyoming, the state insurance department said it lacks regulatory authority for the reform law, reported Kaiser Health News.

And in Pennsylvania, which hasn't officially declared its position, Insurance Commissioner Michael Consedine said his insurance auditors could add reform law provisions to their annual audits, but he's unsure whether they can legally penalize violators. What's more, the state lacks funding to sufficiently enforce the federal law. "We may need help with having the dollars to do this," he told KHN.

The HHS Center for Consumer Information and Insurance Oversight has written letters to these states, explaining it will assume regulatory authority. The problem, though, is HHS has little experience regulating all the various state insurance markets and few resources to take on that new responsibility, noted KHN.

Even HHS's own Gary Cohen, who heads its CCIIO office, has said states are better positioned to regulate insurers because they already enforce state health insurance laws.

To learn more:
- read the Politico article
- see the Kaiser Health News article

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