The Senate Finance Committee met yesterday for a lengthy two-part hearing about the implementation of health insurance exchanges. The hearing was notable for two key reasons: it provided the greatest amount of insight as to where HHS is in the federal exchange development process to-date and it featured biting criticism and skepticism of the Administration’s progress so far from five key Democrats; Finance Committee Chairman Max Baucus (D-MT) and Senators Maria Cantwell (D-WA), Tom Carper (D-DE), Bill Nelson (D-FL) and Ron Wyden (D-OR).
Baucus came right out and told the Director of Center of Consumer Information and Insurance Oversight (CCIOO) Gary Cohen that HHS “needs to get moving.” Cohen oversees exchange development and health reform implementation for HHS and Senator Tom Carper was very stern when he warned him, “You really need to be on your A game.” Senator Johnny Isakson (R-GA) warned Cohen about the strong potential HHS would crash and burn too.
A lot of time at the hearing was spent on the federal data hub, which will help generate an individual’s eligibility for exchange-based subsidies. The data hub is extraordinarily complex and needs to pull data from many federal agencies including the Department of Homeland Security and the Internal Revenue Service. There are so many offices that will have to contribute information that Cohen could not even list them all during the hearing. Xerox made a chart that explains the fairly convoluted potential process which Cohen had trouble explaining.
The second part of the hearing featured testimony from Director of Rhode Island Health Benefit Exchange Christine Ferguson, Chair of the Delaware Health Care Commission Bettina Tweardy Riveros, and Don Hughes, an advisor to Arizona Governor Jan Brewer. Hughes made some interesting comments about how Arizona, a very red state, had done a huge amount of work to plan a state-based exchange and was well positioned to open one on-time. However, since HHS was unable to answer many key questions about how things would work by the state deadline, the governor ultimately opted for a federally facilitated exchange instead. If you have a spare hour or so to watch and you are interested in insurance exchange development, you will probably find it worthwhile to watch the hearing video!