On Monday, Kathleen Sebelius, Secretary of the Department of Health and Human Services, unveiled a sleuth of federal rules that are to be used in governing health insurance exchanges. The rules, which will be in effect regardless of whether states choose to set up and exchanges themselves or pass that burden to the federal government, have a particular leaning in favor of insurers. This has drawn sharp criticism from legislators and the public, as the exchange programs have always been lauded as being consumer friendly. Now, there are concerns that this claim may be far from accurate, as insurance companies stand to receive some of the freedoms for which they had been fighting for.
Until now, the provision of the Affordable Care Act which required states to form exchanges has been met with mild acceptance. While many states have railed against the notion of the federal government exerting control over the programs, they have been keen to follow the guidelines provided by the government to ensure control of the exchanges stays firmly within their hands.
According to the new rules laid down by Sebelius, states will not be able to negotiate with health plans on price and benefit design. Certain plans will also no longer be excluded from exchange programs if they do not meet specific criteria. Furthermore, insurers will be able to appoint their own people to govern the exchanges, in accordance with the federal health care law.
Sebelius says that the new rules are meant to ensure that insurers still have a place in the changing market. Consumer advocacy groups, however, decry the new rules as being too much in favor of the insurance industry.
