Carriers without products for sale through DC Health Link haveno interest in paying fees to support it.

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Insurers and their trade groups are trying to keep the body incharge of the exchange, the D.C. Health Benefit Exchange Authority,from using a broad-based “health carrier assessment” to supportit.

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The Patient Protection and Affordable Care Act requires managersof locally based exchanges to come up with their own revenue by2015.

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Only four carriers sell coverage through the D.C. exchange, andthe district obviously has a small market.

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D.C. exchange managers proposed making up for those limitationsby having a wide range of carriers – including issuers of dental,vision, critical illness, and other products not sold through theexchange – join the others in paying user fees.

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Wes Rivers, a policy analyst at the D.C. Fiscal PolicyInstitute, wrote a comment letter supporting the proposal.

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Even though carriers issuing disability insurance, long-termcare insurance and other “excepted products” cannot sell theproducts through the exchange, PPACA will help them by helping moreD.C. residents get medical coverage, Rivers writes.

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Expanded access to coverage should make D.C. residentshealthier, and that should eventually make the residents betterrisks for non-medical, health-related products, Rivers says.

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In addition, imposing the assessment on the large group planssold outside the exchange should help keep large employer plansfrom having an edge over small group plans, Rivers says.

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Laurie Kuiper of Kaiser Permanente – an exchange participant –says Kaiser wants to the assessment base to be as broad aspossible.

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But representatives from America’s Health Insurance Plans, theAmerican Council of Life Insurers and the Self-Insurance Instituteof America Inc. blasted the idea of requiring off-exchange carriershelp pay for the exchange and questioned whether the district hasthe authority to impose a broad assessment.

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AHIP, for example, believes the exchange authority only has theauthority to impose user fees and licensing fees on sellers ofqualified health plans and qualified dental plans, according toGeralyn Trujillo, an AHIP regional director.

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Catherine Bresler of Trustmark Insurance Co. says a broadassessment would be unfair to insurers and policyholders that getno benefit from the existence of the exchange.

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Some commenters suggested that the District of Columbia shouldconsider using general fund money to support the exchange, and somesuggested or implied that insurers might be more open to paying anexchange assessment while the exchange is building enrollment.

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John Fleig Jr., chief operating officer of UnitedHealthcareMid-Atlantic Plan, suggested replacing the open-ended assessmentobligation with an assessment program that would last for just twoyears.

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See also:

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Allison Bell

Allison Bell, ThinkAdvisor's insurance editor, previously was LifeHealthPro's health insurance editor. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached at [email protected] or on Twitter at @Think_Allison.