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Kansas Health Exchange Profile


Kansas

Establishing the Exchange

After placing health insurance exchange planning on hold until after the November elections, Governor Sam Brownback (R) announced on November 9, 2012, Kansas would default to a federally-facilitated exchange.

With the initial endorsement of the Governor in 2011, Kansas Insurance Commissioner Sandy Praeger, had established eight exchange planning work groups comprised of hundreds of volunteers across civic groups, government agencies, and the insurance and health care industries. The work groups met regularly from the spring of 2011. The work groups reported to the Health Benefit Exchange Steering Committee, housed within the Insurance Department. Work group reports adopted by the Steering Committee include recommendations regarding oversight of navigators, limiting the number of insurance carriers in the exchange, the role of agents and brokers, the number of exchanges the state should have, and a consumer outreach and education plan.

In May 2011, Governor Brownback signed into law a measure prohibiting health plans operating within a Kansas exchange from offering abortion services unless the pregnant woman’s life is in danger (HB 2075). The purchase of optional riders for abortion coverage in these plans is not allowed.

Contracting with Plans: On February 15, 2013, Commissioner Praeger sent a letter to the Center for Consumer Information and Insurance Oversight (CCIIO) requesting to maintain control over plan management functions despite not having entered into a state-federal partnership exchange. The Kansas Insurance Department (KID) intends to utilize the System for Electronic Rate and Form Filing (SERFF) to review health plan rates, covered benefits, and cost-sharing requirements for purposes of certifying qualified health plans (QHPs). KID will also manage consumer complaints, ensure continued plan compliance, and oversee decertification of issuers. Commissioner Praeger attested that Kansas has the legal authority to conduct plan management functions necessary to support certification of QHPs, as required by the Affordable Care Act.

Essential Health Benefits (EHB): The Affordable Care Act requires that all individual and small-group plans sold in a state, including those offered through the Exchange, cover certain defined health benefits. States must decide whether to benchmark their EHB plan to one of ten plans operating in the state or default to the largest small-group plan in the state. In October 2012, the Insurance Department submitted an EHB benchmark plan recommendation to the Governor of Blue Cross Blue Shield of Kansas Comprehensive Plan.

Exchange Funding

In September 2010, the Kansas Insurance Department received a $1 million federal Exchange Planning grant. The Department also received a $31.5 million federal Early Innovator grant to develop an exchange information technology infrastructure that could be replicated by other states. The state planned to extend the new Kansas Medicaid/Children’s Health Insurance Program eligibility system to provide eligibility and enrollment services for an exchange. However, on August 9, 2011, the Governor announced the state would return all Early Innovator grant funding.

Next Steps

On March 8, 2013, Kansas received approval from CCIIO to perform plan management activities. The federal government will retain control over all other Exchange functions.

For additional information on the Kansas health insurance exchange visit:http://www.ksinsurance.org/consumers/healthreform/aca.htm


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