Healthcare Reform Receiving Finishing Touches After The Fact

Healthcare Reform Receiving Finishing Touches After The Fact

Speaker of the House of Representatives Nancy Pelosi was widely ridiculed earlier this year, when she said that healthcare reform legislation would have to pass before people could know what was in it. Although all 2,000-plus pages of the bill were publicly available on the Internet for viewing and download, she had a point.

Many of the effective elements of the legislation are not actually spelled out in the bill itself. Instead, various federal agencies are given the responsibility to craft appropriate regulations. These include the exact level of subsidies individuals and businesses will receive, the minimum coverage levels health insurance companies will be required to offer, and the rate increases that will draw scrutiny for being "unreasonable".

One of the agencies mainly responsible for those guidelines is the Department of Health and Human Services. Its secretary, Kathleen Sebelius, has been a staunch supporter of health insurance reform from its initial stages.

Insurers are waiting with bated breath to see how several new HHS appointees affect them. They are very interested in finding out what costs of theirs will be considered legitimate medical expenses, therefore keeping them above legally mandated medical loss ratio levels. The exact guidelines will be decided in bureaucratic buildings, not the Capitol. A likely major player is Jay Angzoff. He is the new Commissioner of Consumer Information and Insurance Oversight, and is known for taking a hard line against health insurers in the past.

The Labor Department also plays a significant role. That department is the home of the Employee Benefits Security Administration, which oversees the health insurance plans offered to federal employees. Secretary Phyllis Borzi has useful experience in using large group buying power to negotiate lower rates for large groups that will be helpful in creating the insurance exchange programs that will launch in 2014.

These departments, as well as the Treasury Department and the Office of Management and Budget, are being closely guided to the White House towards a common goal. The Office of Healthcare Reform, directed by Nancy-Ann DeParle, is holding regular meetings to coordinate all of their efforts.

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