MILWAUKEE PROFESSIONALS ASSOCIATION LLC

www.mpapublicpolicyreview.blogspot.com October 5, 2012 414.610.1044

TO:

Commissioner Ted Nickel WI Office of Commissioner of Insurance MARY GLASS Chair/CEO MILWAUKEE PROFESSIONALS ASSOCIATION [MPA] AFFORDABLE HEALTH CARE ACT BENCHMARK SEPTEMBER 30, 2012

FROM:

RE:

Greetings Commissioner Nickel! This is a Request for a Status Report regarding Wisconsin Affordable Health Care Act/ACA Implementation. It is also to express some concerns. We notice that from your website, you have posted a letter sent to Secretary Kathleen Sebelius that speaks to why you were not able to satisfy the September 30, 2012 timeline for the Essential Health Benefit Benchmark Plan/EHBBP. We are most concerned since Governor Scott Walker has publically stated a stall until after the November 6, 2012 election. According to the ACA timeline and blueprint, the September 30, 2012 EHBB plan has many issues of concern that must be loaded. We also know that the September 30, 2012 is a soft date allowing additional time. That being said, we are interested in how far along your office and Secretary Dennis Smith, Wisconsin Department of Health Services, are in ensuring that we, the People of Wisconsin, are moving along with other issues that must be loaded that are already known.

2 COMMISSIONER TED NICKEL REQUEST INSURANCE STATUS REPORT FOR SEPTEMBER 30, 2012 BENCHMARK AFORDABLE HEALTH CARE ACT

The following twenty-three (23) questions are requested for your immediate response. They are: 1. Affordable Health Care Act federal law will preempt any state law. However, for edification, do we have a Wisconsin law that prevents the implementation of the Affordable Health Care federal law? If so, what is the statute? What is in place for Wisconsinites 100%-400% below poverty? What about the subsidies and when are they affected? What exactly have you done regarding market reforms Inside market and outside markets? What has your office provided for the insurance companies for product development? Since they must be able to share with the public by the last quarter of 2013. What are the guarantee issues for Wisconsinites? What is in place for the rating reform for Wisconsinites no annual or lifetime limits?

2. 3. 4.

5.

6. 7.

Benefits package in the individual markets 8. What about the actual value for metal levels (bronze, silver, gold, platinum and catastrophic plan)? 9. What is your office position regarding the findings of Gorman Actuarial, LLC? What about the 3-year reinsurance windfall (billions of $$$) shifted down to individual market? How will this take place? When? What is the criteria for selection of the company for reinsurance?

10.

11.

3 COMMISSIONER TED NICKEL REQUEST INSURANCE STATUS REPORT FOR SEPTEMBER 30, 2012 BENCHMARK AFORDABLE HEALTH CARE ACT

12.

Who are the following: 3 largest federal employee groups 3 largest state employee groups 3 smallest group largest HMO? What specifics are given to Open Enrollment in both the inside and outside markets? We are about to enter the 2012 Open Enrollment season for social security recipients for annual selection What is being shared with Wisconsin recipients in planning for upcoming Affordable Health Care Act implementation? What attention has been given to the Medicare options of the ACA EXPANSION (133% of poverty)? What role has/will the PUBLIC play in the selection of the selected Exchange insurance and the reinsurance company? What has your office done in the area of policies regarding security and privacy that are compatible with HIPAA/The Health Insurance Portability and Accountability Act (HIPAA)? What are the state laws related to security and privacy, especially when dealing with EHR/electronic health records and mobile devices for ODLB/Observation of Daily Living Behaviors? What audiences of the public have you visited for personal appearances to share information about the Affordable Health Care Act? What has been you office (staff) record for initiating outreach and engagement of the public this year? What is the plan of engagement of the public?

13.

14.

15.

16.

17.

18.

19.

20.

21.

4 COMMISSIONER TED NICKEL REQUEST INSURANCE STATUS REPORT FOR SEPTEMBER 30, 2012 BENCHMARK AFORDABLE HEALTH CARE ACT

22.

What funds are available for entrepreneurs for engagement of the public? My office is interested in such funding. What role has your office been in the follow-up of the Metastar Extension Consortium for IT/Information Technology outreach to Health Care Practitioners? If none, why not?

23.

November 16, 2012 Application Due The timeline to January 1, 2014 is below for mandates known. They are: September 30, 2012 - Essential Health Benchmark `November 16, 2012 - Applications Due January 2013 - HHS Certifies State Exchanges October 2013 - Initial Open Enrollment Period January 2014 - Exchange Coverage Effective Establishment Grants - Available through 2012

The next mandate is 10 days after the November 6, 2012 election. Where are we with that? Will we be ready with the expectation known for preparedness of implementation of the ACA? All Hands on Deck, WE Can Milwaukee Professionals Association LLC is providing leadership in the city of Milwaukee at the neighborhood level to engage the citizenry, state, regional and federal government. We know if the people are to benefit, the people MUST be informed and contributing their fair share of the engagement and decision making. We have scheduled four briefings and an introductory IT EXHIBIT for the year 2012. The kick-off was Wednesday, September 19, 2012. It is amazing how much dragging-of-feet my office received from designated individuals at both the state and federal level for engagement and information sharing basics to IT designs. This behavior from our government staff is out-of-order; and, we look for much more timely and responsible support going forward for the other four events below that we have scheduled.

5 COMMISSIONER TED NICKEL REQUEST INSURANCE STATUS REPORT FOR SEPTEMBER 30, 2012 BENCHMARK AFORDABLE HEALTH CARE ACT

Next Date: Wednesday, October 24, 2012 The theme is: IT/Information Technology and Health Care Host-n-Learn TIME: 9:30AM - 11:45AM TIME: 12:15pm - 1:30pm TIME: 2:00PM - 4:30PM ================== (Session I) (Session II) (Session III)

For our next briefing, we have asked your office specifically for more than one speaker for Host-n-Learn. Host-n-Learn is my office re-ordering engagement judging from lack of participation the kick-off. It calls more for All Hands on Deck, WE Can engagement and responsibility. This is where the speakers from your office and other lead departments (federal-state-regional-county-city) go to at least two sites on October 24, 2012, to talk with residential and commercial stakeholders as well as health care providers about the implementation of the Affordable Health Care Act. Host-n-Learn is my office re-ordering engagement judging from lack of participation and cost for the kick-off. It calls more for All Hands on Deck, WE Can engagement and responsibility. The engagement will give your office as well as the end-users an opportunity to fine-tune the process for our state. It will help eliminate gaps for navigating the insurance marketplace inside and outside markets. We are also including practitioners/caregivers. We seek and expect your office, Secretary Dennis Smith (DHS), Secretary Reggie Newsom (DWD) to extend the services and resources of your office for the engagement and improved knowledge of Milwaukeeans. Attorney Laura Brown Office of Commissioner of Insurance We are most appreciative for the visit of Attorney Laura Brown from the Office of Commissioner of Insurance. It was an of-benefit meeting of the minds between my office and Communication Director JP Weiske Office of Commissioner of Insurance after your unavailability.

6 COMMISSIONER TED NICKEL REQUEST INSURANCE STATUS REPORT FOR SEPTEMBER 30, 2012 BENCHMARK AFORDABLE HEALTH CARE ACT

Attorney Brown was joined by Meagan Wolfe of the Government of Accountability Office, Lori Obluck of the Arthritis Foundation, Ester Hubbard, IT Image Consultant; and, our own Milwaukee County Supervisor Willie Johnson, Jr. District 13. Their professionalism and flexibility to get-the-job-done at our kick-off September 19, 2012 is commendable. MPA LLC other briefings are: Wednesday, October 24, 2012 Wednesday, November 14, 2012 Wednesday, December 19, 2012 Introductory IT EXHIBIT Wednesday, December 19, 2012 Right-back response We would like a timely response from the Office of Commissioner of Insurance on this requested status report for the people. We ask your response within 7 business days (October 16, 2012).

With Affordable Health Care Act in Mind,

With Recovery in Mind, _______________________ Mary Glass Chair/CEO/Founder Milwaukee Professionals Association [MPA] www.mpapublicpolicyreview.blogspot.com http://cncfnbamilwaukee.newsvine.com 414.610.1044

cc: U.S. Congresswoman Gwen Moore 4th District Governor Scott Walker Wisconsin Supervisor Willie Johnson Jr. Milwaukee County Secretary Kathleen Sebelius USGovHHS Secretary Mike Huebsch State Administration Secretary Dennis Smith DHS Secretary Reggie Newsom DWD JP Wieske Communication Office of Commissioner Attorney Laura Brown Office Commissioner of Insurance Dr. Courtney Williams HHS/CMS/CCIIO Attorney Leon Rodriguez HHS Civil Rights Dr. Farzad Mostgashari HHS IT Brian Webb Manager, Health Policy & Legislation Josh Goldberg Health Policy & Legislative Advisor Jolie Matthews Senior Health & Life Policy Counsel