Hamm: ND could let feds change insurance exchange

FARGO - North Dakota's top insurance regulator told lawmakers Friday that it might be wise to let the federal government take the lead in establishing a new health insurance exchange that is part of health reform.

FARGO - North Dakota's top insurance regulator told lawmakers Friday that it might be wise to let the federal government take the lead in establishing a new health insurance exchange that is part of health reform.

Insurance Commissioner Adam Hamm told an interim legislative committee that the federal government would allow states to later assume control of the exchanges, online marketplaces intended to make it easier for consumers to shop for coverage.

That new flexibility, granted under federal rule changes announced late last month, provides an option as states grapple with daunting challenges to set up the exchanges by 2014 but must be certified by the beginning of 2013, Hamm said.

The newly available option for the state to later assume control of an exchange prompted Hamm to rethink his earlier position that North Dakota should move at the onset to create and operate its own health insurance exchange.

"The feds would take all the risk," Hamm told members of the Legislature's Health Care Reform Review Committee, meeting in Fargo.


Hamm, an outspoken critic of federal health reform, called the flexibility for states to first step aside and let the federal government set up the exchanges with the option of later assuming responsibility a "bombshell."

But the reaction to that idea from Rep. George Keiser, R-Bismarck, chairman of the health review committee, was cool. He asked Hamm to cite one program run by the federal government that operates more efficiently than the state version.

"If the states have been given the right to run it, we can do a better job," Keiser said.

In other developments:

E The panel learned a consultant's report to help guide the state in implementing the exchanges will not be complete in time for a planned November special session.

"We're doing the best we can," Hamm said, but the review can't start until late this month when the consultant is chosen. He said an interim report will be drafted, with the final version expected in December.

E Hamm and legislators who spoke at Friday's meeting favor separate pools for individual and group health insurance. Also, those who spoke appear to favor allowing both individuals and employer groups the option of buying health insurance sold outside the exchanges.

"We're not advocating for one pool," Hamm said, adding he is concerned about the possibility that groups, which have lower administrative costs, could end up subsidizing individuals.


E A recent decision by federal officials not to allow four health insurers in North Dakota the ability to have lower ratios for medical losses threatens the state's efforts to invite more competition, Hamm said.

The decision, announced last week, means insurers immediately will have to pay out at least 80 cents for every health insurance premium dollar collected. So far, no companies have announced they intend to leave the state, Hamm said.

Still, the four insurers cover 8,000 enrollees, and up to 16,000 people. Four years ago, North Dakota relaxed its standard from 65 percent to 55 percent in a move to invite more companies to enter the market.

Six new health insurance plans have been introduced in the past couple of years, Hamm said.

E If a special congressional committee fails to reach agreement on a way to reduce the federal debt, grants to states to set up the exchanges could be in jeopardy, Hamm said.

Readers can reach Forum reporter Patrick Springer at (701) 241-5522

Related Topics: HEALTH
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