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Posts tagged: ACA

Exchange board commissions independent review of no-bid contract snafu

Idaho’s health insurance exchange board, after an hour and a half closed-door executive session to discuss personnel matters, returned to open session and voted unanimously this afternoon to commission an independent review of what happened when a no-bid contract was awarded to a board member who then resigned. “We will be working to find an attorney to do that review for us,” Board Chairman Stephen Weeg said after the meeting, “to look at what happened, and how that might have happened, and what recommendations they would make for us as an organization.”

The motion was made by board member Jim Rice and seconded by board member Hyatt Erstad. Weeg said the board wants to do better. “We’ve operated under a crisis mode for five months, and it’s time to stop and take a breath,” he said.

The exchange’s executive director, Amy Dowd, awarded the $375,000 contract last week to board member Frank Chan, who then resigned from the board. Yesterday, Chan agreed to cancel the contract and offered to work with the board on IT issues over the next month, but at its meeting today, the board declined that offer, ending all work under the contract immediately. It also voted to require that in the future, any contract for more than $15,000 be brought to the board for approval.

“It was a long, deliberate, informed, civil discussion,” Weeg said. The board is scheduled to meet again Oct. 30. Weeg said it hopes to receive the review from the attorney in executive session. Asked if the results then will be made public, Weeg said, “I think I will have to see what those findings say before I can give you a definitive answer.”

Exchange votes to require board approval for all contracts over $15,000

Idaho’s health insurance exchange board has voted to forbid issuance of any contract for more than $15,000 without board approval, filling in blanks in the exchange’s interim procurement policy that set no limit – and allowed board Executive Director Amy Dowd to issue a now-cancelled no-bid $375,000 contract to a board member last week. “If an expenditure is to exceed that, that will be brought before the board to make a decision,” said board member Hyatt Erstad, who made the motion. “It’s not designed to hamstring. It’s designed to allow us additional accountability,” he said. “That could be adjusted on a going-forward basis.”

Rep. Kelly Packer, R-McCammon, said, “I think we’re moving in the right direction. I like the idea of having an interim dollar amount to put in those blanks,” while the exchange finalizes its overall procurement policies. Erstad’s motion also required that the final procurement policy – addressing a series of other details about contracting, sole-source contracts and required reviews – be presented to the board for approval by its next meeting. The board approved the motion unanimously.

Exchange board: ‘There should have been some alarms going off’

Idaho health insurance exchange board member Kevin Settles lauded former board member Frank Chan for the time, effort and expertise he offered to the board before his resignation last week, as he was awarded a now-canceled, $375,000 no-bid contract. “I thought that he was a tremendous benefit for the board and really appreciate him,” Settles said. He expressed hope in “the possibility of extending a contract with him in a better fashion,” and added, “I just feel bad for Frank, and for all of us. But we shouldn’t dogpile on it.”

Board member Jim Rice, a Caldwell state senator, countered, “Negotiation of the contract prior to the resignation – Idahoans don’t see that as appropriate, we just don’t. … It’s part of being a fiduciary.” He said, “I think that from here, we can’t contract with him. … We have to deal with reality, and reality is that I don’t think we can do further business with Frank, in spite of the fact that he did volunteer a lot of his personal time while he was on the board and went above and beyond. It was something that was very commendable. … I don’t think it is something where we can just say we’re going to ignore that going forward. We can’t. There’s a lot of realities that come with this particular entity that don’t exist with other entities.”

Board member Tom Shores said the process was flawed. “There should have been some alarms going off,” he said. “All those things should have occurred and didn’t occur.”

Board Chairman Stephen Weeg said, “My hindsight says that in some ways our desire for expediency overcame … our desire for good governance. … So we made a decision, a decision was made regarding hiring one of our board members … and it created a major mess for us, there’s no way to ignore that fact. So we need to look at that as a board.”

“We’re all in this together,” Weeg said. “We could spend time trying to figure out who did what wrong, and I’ll take some of the blame for that. The governor appointed me to chair this board and the governor can decide if I still have his full faith and confidence, and I’ll need to talk to him about that. But I think the goal today is to say we have a huge challenge, we have a significant issue that we need to address and do better together. … We’ve been pressed by time from the get-go. We’ve probably taken some shortcuts that have caused us to stumble.”

No-bid contract with exchange board member has been canceled

Former Idaho health insurance exchange board member Frank Chan, who last week was awarded a no-bid, $375,000 IT contract with the exchange and then resigned from the board, has now “exercised his right to cancel the contract,” exchange board Chairman Stephen Weeg announced this morning, at the opening of the exchange board meeting. “There’s a 30-day cancellation clause in that,” Weeg said.

Amy Dowd, exchange executive director, said, “I made the decision to contract with Applied Computing because they have the background and experience needed for this challenge. The questions that have been raised indicate this decision should have been made in a different way. … I understand the scrutiny we are under. I appreciate the concerns that have been expressed this week. … I have learned from this process.”

Two lawmakers on exchange board want no-bid contract with board member voided

Two state lawmakers who serve on the Idaho health insurance exchange board are calling for voiding the no-bid contract awarded last week to board member Frank Chan, who then resigned from the board, the AP reports. The contract called for Chan to be paid $180 an hour, up to $375,000, to oversee the exchange's technology vendors; he formerly headed the board's technology committee. Sen. Jim Rice, R-Caldwell, told the AP, “When somebody is going behind everyone's back, negotiating a contract for themselves at $180 an hour when they've got current contracts with the state at $95, I don't think that's even ethical. It's not in the interest of the citizens of Idaho and it's a violation of the fiduciary obligation of a member of the board.” Rep. Kelly Packer, R-McCammon, said, “Things have been out of control because we were in a hurry. It's time to have a longer thought process, to get things back in line.” The board meets this morning at 11.

Exchange board to meet Tuesday to discuss procurement, after flap over no-bid contract with board member

Here's a news item from the Associated Press: BOISE, Idaho (AP) — Idaho's insurance exchange board meets Tuesday to discuss how it buys services after state lawmakers criticized a $375,000 no-bid contract awarded to one of its members. The Your Health Idaho exchange board meets at 11 a.m. to discuss its procurement process. On Friday, House Speaker Scott Bedke called it “indefensible” for exchange director Amy Dowd to give board member Frank Chan a big technology contract without advertising it publicly or letting others bid. Chan quit the board Wednesday after getting the contract. Though Dowd insists she has the authority to award contracts like the one with Chan, the exchange is operating under only a “draft” procurement policy that doesn't specify when bidding must be competitive. The board said in May it would finalize that policy. That's so far not happened.

House speaker calls no-bid contract with exchange board member ‘indefensible’

Idaho House Speaker Scott Bedke said Friday that it was “indefensible” for the state's health insurance exchange to award a no-bid contract worth up to $375,000 to one of its own board members, the AP reports, who then resigned from the board. Bedke, R-Oakley, told the Associated Press, “It was wrong. … I'm very troubled by what has happened. I understand the board is going to revisit this issue, and I'm willing at this point to let the board do its job. The public has a right to have confidence in all governmental processes, including this one.”

Board member Frank Chan resigned from the board Wednesday, when the deal to give him a $180 per hour contract to oversee a technology project was announced; click below for a full report from AP reporter John Miller.

Health care reform opponent has 10 kids on Medicaid

A tea party legislative candidate from Canyon County has become the target of national online derision, the Idaho Statesman’s Dan Popkey reports, after news surfaced that while he opposes Obamacare and will pay a penalty rather than participate, he has 10 kids on Medicaid, the government-funded health care program for the poor and disabled. “I attracted all the attention of all the people who hate Republicans and the tea party,” Greg Collett, a 41-year-old freelance software developer and University of Idaho alum, told Popkey. “I've also attracted the attention of a lot of people in the liberty movement that don't want to see anybody on welfare.” Things got so bad, Collett said, he had to clean up his Facebook account and remove contact information from his campaign website.

 

The two-time GOP legislative candidate, who’s planning to run again, made the news because he was one of 1,503 people who answered a Kaiser/NBC poll in September about attitudes about the Affordable Care Act, and he told the pollsters he'd be willing to talk to a reporter. He ended up as the first person quoted in an Oct. 4 NBC story, “Health care holdouts: uninsured but resisting.” It went viral.

 

“I'm OK taking whatever I can from the government that's available to me,” Collett told Popkey. “I'm not going to lie and scam the system, but I'm OK with redirecting that money away from morally reprehensible things and direct it towards me.” Popkey’s full report is online here, along with links to some of the national stories and Collett's online response.

Idaho exchange board member quits, gets big no-bid contract

A board member of the Idaho health insurance exchange quit Wednesday, the same day the exchange awarded his company a no-bid contract worth up to $375,000, the Associated Press reports. Frank Chan resigned from the Your Health Idaho board to avoid the appearance of conflict of interest, board members said. Chan's company, Boise-based Applied Computing, will serve as the exchange's information technology consultant; click below for a full report from AP reporter John Miller.

Earlier this year, Miller reports, Chan was appointed by Gov. C.L. “Butch” Otter to help oversee the Internet marketplace created under President Barack Obama's health care overhaul. It allows people to shop for insurance and learn if they qualify for federal subsidies. He had been technology chairman of the 19-member volunteer board. Chan will now earn $180 an hour to oversee the exchange's technology vendors as it works to replace a glitch-filled federal software system with one that's state-based by next year. The exchange is seeking a $50 million, taxpayer-funded grant from the federal government to pay for that project.

Idaho insurance exchange could raise its per-policy fee by 2016

Idaho's state health insurance exchange, Yourhealthidaho.org, has been touting the big savings it offers Idahoans over a federal exchange, since its fee on policies has been set at just 1.5 percent, compared to 3.5 percent for federally run exchanges. But the Associated Press reports that emails obtained under the Idaho Public Records Law show exchange officials have been discussing a possible hike in that fee to 2.6 percent by 2016, to meet requirements that the exchange be self-sustaining by then. That would still offer savings compared to a federal exchange, but would be significantly higher than the current fee, cutting into the amount of savings for Idahoans.

Exchange finance chief Pat Kelly planned a presentation to the exchange's finance committee in early September on the possible fee hike, but executive director Amy Dowd canceled it, saying the numbers were too preliminary to be ready for public consumption. “The reason we weren't comfortable publishing 2.6 percent is, we have no clue what the number is going to be,” Dowd told the AP. “We've done some modeling, we've got some data, but as far as our comfort level, putting a number out today is not a wise decision.” Click below for a full report from AP reporter John Miller.

Idaho insurance exchange reports progress, despite slowdowns…

Idaho’s new health insurance exchange still is seeing frustrating computer system delays, but it’s accomplishing its other goals, state lawmakers heard this morning: In-state people are taking the calls from consumers, the state’s Department of Insurance is regulating the plans offered, and buyers are being referred to Idaho insurance agents and brokers. Plus, Idahoans should save millions over the coming year, compared to the cost of letting the federal government run its exchange. That’s because buyers of plans on federally run exchanges pay a 3.5 percent fee to cover the cost of the exchange; Idaho’s fee is just 1.5 percent. The Legislature’s joint Health Care Task Force heard a report on the exchange’s progress at its meeting today; you can read my full story here at spokesman.com.

Idaho exchange premiums come in below average of states

Idaho’s premiums through its new state health insurance exchange so far are coming in below the average, Joy Wilson, director of health and human services policy for the National Conference of State Legislatures, told Idaho lawmakers this morning. “The rates vary tremendously from state to state,” Wilson told the Legislature’s joint Health Care Task Force. She offered some figures for a 27-year-old, before any tax credits: For the lowest “bronze” level benefit plan, the average was $163 a month; Idaho’s rate is $150. For the lowest silver plan, average was $203, Idaho’s is $182; and for the lowest gold-level plan, average is $240 and Idaho’s rate is $211. For catastrophic plans, Idaho was slightly above the average for a 27-year-old, at $134, compared to $129.

Alaska and Wyoming have the highest rates, Wilson said, because “they’re people-challenged – they don’t have a lot of people, so there’s not a lot of competition. And their rates reflect that.” She said, “We’ll have to see where rates go over time. … Insurers are being cautious. Most of them are staying in markets that they’re familiar with, they’re not branching out.”

Wilson told lawmakers the initial comparisons show “you come out pretty well, actually, in terms of your rates. And this will make a difference, of course, in terms of your take-up. Rates are going to be very important, particularly to the young people.”

Exchange officials offer advice to those who experience online delays

After two days of operation of Idaho's health insurance exchange, Executive Director Amy Dowd is offering this advice to those who are experiencing delays once they hit the federal application website, to which they're routed from Idaho's Yourhealthidaho.org site: “For those who may be having difficulty, when you get to the healthcare.gov application, you may see a 'holding page' for a few minutes before you enter the application process. If you're at the holding page, do not refresh your browser or leave the page. If you do, you will lose your place in the virtual line to get into the application.”

Dowd said Idaho's Yourhealthidaho.org site had 18,000 unique visitors its first day alone. In the first two days, Idaho's call center took more than 800 calls and answered more than 100 emails.

“Due to the high volume of interest, our application through healthcare.gov has been experiencing longer than expected processing times,” she said. “We know that this is frustrating, but we really appreciate everyone’s patience. We have heard that Idahoans are getting through and that applications are processing.” Click below for Dowd's full statement.

Idaho insurance exchange up and running…

Things are busy at Idaho’s health insurance exchange today as enrollment opens, but the system hasn’t crashed as several other state exchanges around the country have reported. Instead, there are slowdowns, but everything’s functioning, and the state’s in-person assistants and insurance agents and brokers have been able to access the system. “It really is a higher volume than I think a lot of people may have thought, but it’s a positive response at this point,” said Alberto Gonzalez, operations manager for the Idaho exchange, Yourhealthidaho.org.

Ten workers at a temporary Boise call center have been taking calls non-stop all morning; Gonzalez said the average wait time has been only a minute and a half, with the longest wait at 5 minutes. “I think we’re handling the calls pretty well,” he said. Across the state, 120 in-person assisters have been trained to help people navigate the exchange, including figuring out what kind of help they may be eligible for, and how to compare and choose health insurance plans. Callers or visitors to the website can be referred to in-person assisters, agents or brokers in their area.

Idaho’s exchange website, for now, routes applicants to the federal exchange website for signups, but the state is developing its own. “We could not get the technology in place in just a few months,” Gonzalez said. But he said by a year from now, in October of 2014, “We’ll be on a full state-based exchange technology.”

Exchange officials stressed that whether people sign up today or any time between now and Dec. 15, coverage will start Jan. 1.

For Idaho uninsured, exchange starts Tuesday

Idaho’s state health insurance exchange opens Tuesday, allowing about 200,000 uninsured Idahoans to begin enrolling in health insurance plans; the coverage starts Jan. 1. Amy  Dowd, a health care consultant hired in April to run Idaho’s exchange, told the AP’s John Miller, “We don't have a set target we're expecting for enrollment. Our goals for our open enrollment period are to educate, get the word out that this is available.” Click below for Miller’s full report on the exchange startup, including a by-the-numbers roundup of costs, salaries, carriers, where to call and more.

Meanwhile, S-R reporter John Webster has a report here on the health care reform law changes and what they mean for you, whether you’re on Medicare or Medicaid, insured through your employer, have individual coverage now or are uninsured.

Labrador co-sponsors bill to avert government shutdown only if health reform defunded, delayed

1st District GOP Congressman Raul Labrador announced today that he is co-sponsoring a resolution introduced today by Rep. Tom Graves, R-Georgia, to avert a government shutdown Oct. 1 only if President Obama's health care law is both de-funded and its individual mandate to purchase insurance delayed for a year. “If there’s any single issue that can unite House Republicans and has the strong support of the American people, it’s getting rid of ObamaCare,” Labrador declared. “The resolution I’m cosponsoring will keep the government open while keeping overall spending at the same rate the Senate has already agreed to through the sequester.  House Leadership should bring it to the floor for a vote.  If the House passes it and the Senate rejects it, it will be the Senate that’s responsible for shutting down the government.  Let’s hope it doesn’t come to that, but House Republicans must seize this opportunity to keep our promises to the American people on ObamaCare.” 

Click below for Labrador's full news release. Meanwhile, President Obama, in a White House speech yesterday, blasted House Republicans who are taking that position, saying, “I cannot remember a time when one faction of one party promises economic chaos if it can't get 100% of what it wants.” In his speech, which House GOP leaders criticized as partisan, Obama asked, “Are some of these folks so beholden to one extreme wing of their party that they're willing to tank our whole economy?”

Idaho insurance exchange to offer 161 health insurance plans

Idaho’s state health insurance exchange announced today that it will offer 161 health insurance plans at various coverage levels, from eight providers, when it opens for business Jan. 1; enrollment starts Oct 1. The selection will include 76 individual health plans, 55 small-group health plans for small businesses, 13 individual dental plans and 17 small-group dental plans. “We are pleased that our Idaho insurance companies have offered plenty of plans to choose from,” said state Department of Insurance Director Bill Deal. “We encourage Idahoans to visit Yourhealthidaho.org and speak with a producer or in-person assister to learn more about their options.”

The exchange will allow eligible Idahoans – those who don’t already have employer-provided health coverage, and who fit certain income guidelines – to shop, compare and enroll in the various plans, and access government subsidies, if they qualify, to help offset their costs. Monthly premiums, before any subsidies, will range from a low of $160 for an individual to a high of $1,098 for a family of four. You can read the exchange’s full announcement here.

Idaho insurance exchange goes live on the web with new URL

Idaho’s state health insurance exchange now has a web address: Yourhealthidaho.org. The website was unveiled at a news conference today by Gov. Butch Otter and Idaho exchange executive director Amy Dowd; it’s the site where residents and small businesses can shop for health insurance coverage provided by competing private health insurance companies, with premium costs reduced by federal subsidies; enrollment starts Oct. 1.

“I’m still against Obamacare,” Otter said. “But I recognize we do have an obligation. If Obamacare does happen to go away, it does not absolve us right here in Idaho to do what we can to take care of our own.” You can read our full report here from S-R reporter John Webster.

According to the U.S. Department of Health and Human Services, more than 222,000 Idahoans have no health insurance; many of the uninsured work for small businesses or are self-employed. The Affordable Care Act prohibits insurance companies from declining to issue health insurance because an applicant is sick, prohibits higher rates for those with existing health problems, prohibits lifetime or annual caps on the benefits insurance policies will pay, requires coverage of preventive care without co-pays, and requires standard benefit packages so consumers can make apples-to-apples comparisons when selecting a policy.

Idaho insurance exchange inks $1.4 million contract for startup

The Idaho health insurance exchange board has selected Boston-based Public Consulting Group for its biggest contract, for professional services including information technology. The $1.4 million pact runs from July 1, 2013 to Dec. 31, 2014, though either party can cancel with 30 days notice. The firm is charged with handling eligibility and enrollment, consumer assistance, plan management, Medicaid integration and more for the exchange, for both Track 1, in which the exchange will start signing people up Oct. 1 with some assistance from federal systems, and Track 2, in which the full function of Idaho’s exchange will be Idaho-based, including the technology platform.

Paul Buckley, director of government affairs for the firm, said its Idaho exchange work will be managed out of its Denver office. Public Consulting Group is a provider of management consulting services to state, county and municipal governments across the nation, with a growing presence in Canada and Europe as well. It mainly focuses on health care, but has expanded into education, human services, and government information technology as well. You can read the full 22-page contract here; the exchange board announced it at their public meeting Thursday afternoon.

Health insurance exchange board plans extended closed meeting

The board overseeing Idaho's health insurance exchange plans a 3-hour, 40-minute meeting behind a downtown Boise law office's closed doors where citizens will be barred Thursday — nearly twice as long as a public meeting scheduled later that day, AP reporter John Miller reports. Click below for his full report.

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Betsy Z. Russell covers Idaho news from The Spokesman-Review's bureau in Boise.

Named best state-based political blog in Idaho for 2013 by The Fix

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