Insurers should look to their state regulatory officials and lawmakers for healthcare reform guidance since they're the ones who have the most power to regulate and decide uncertain issues with the Affordable Care Act, reported The Hill.
"The states are really where the rubber meets the road on many different levels," Sabrina Corlette, director of the Georgetown University Center on Health Insurance Reforms, told The Hill.
Agreeing with Corlette is Teresa Miller, a healthcare consultant who previously managed state exchanges for the Centers for Medicare & Medicaid Services. "I don't think [states] realize how much power they have in determining how the ACA gets enforced in their state," she said.
Because states hold so much power, compliance requirements vary for insurers--and the federal government doesn't know whether states' standards are actually adequate. The Office of the Inspector General (OIG) found that state standards for access to care for those enrolled in Medicaid managed care programs varies greatly, FierceHealthPayer previously reported.
Additionally, few states will change their oversight of narrow networks to require insurers expand their covered providers despite widespread public outcry concerning the issue.
And states could hamper insurers' efforts to enroll consumers in plans sold on the health insurance exchanges. CMS accused Tennessee officials for failing to take sufficient steps to help consumers sign up for the online marketplace, The Hill noted.
"CMS can offer as many carrots as they can think of to incentivize states to do the right thing, but the only stick they have is to pull out all the funding, and that's the last step that anyone wants to have happen," Sam Brooke, a lawyer with nonprofit law firm Southern Poverty Law Center, told The Hill.
To learn more:
- read The Hill article