Obamacare: The Law of the Land – DC Leads States In Roll Out

Obamacare: The Law of the Land – DC Leads States In Roll Out

. Mohammad Ahkter, MD, Chair, DC Health Benefit Exchange Authority

Following President Barack Obama’s re-election last week, House Speaker John Boehner (R-Ohio) told ABC News that the president’s signature Patient Protection and Affordable Care Act (aka Obamacare) is now the "law of the land." Boehner later walked back that resignation, tweeting: "Our goal remains #fullrepeal." GOP 2012 presidential contender Mitt Romney said if he were elected he would “repeal Obamacare on day one.” With that settled, the States and the District of Columbia are ramping up for full implementation of Obamacare.

“We’d likely be doing a lot of unfortunate back tracking right now [if President Obama had not won the election],” said a smiling Dr. Mohammad Akhter, Chairman of the Executive Board of the DC’s Health Benefit Exchange Authority (HBX) in an exclusive to NuVote Reach/Examiner.com.

“Well, the president won the election, and in this context, that is important. But I can say to you, we had already made very good progress on our future healthcare plans for the District,” he added.

Talk about going all in, starting last summer, Dr. Akhter took a one-year unpaid leave of absence as Director of the DC Department of Health (DOH) to serve on the HBX board charged with guiding implementation of a crucial part of Obamacare – state-level insurance exchanges that will help individuals and small businesses purchase health insurance coverage.

“We are ahead of the rest of the country in developing our plans, with the exception of Massachusetts [with
Romneycare] which has had an established system for some time.

We are very pleased with where we are,” said Akhter.

DC and 13 states gambled a bit in proceeding to meet the Obamacare mandates before the election, while other states were up against a November 16 deadline – now extended to mid December due to the post-election catch-up maneuvering of a number of states – to submit plans to the federal government to set up their exchanges or let the federal government establish one for them. Louisiana and Wisconsin are examples of states opting to let the federal government set up their states’ exchanges – both happen to have Republican governors.

“We fully expect our plan will be approved,” he added.

DC was actually somewhat insulated from the results of the election. It has already passed legislation – the Health Benefit Exchange Establishment Act of 2011 – establishing the health exchange and has received $80 million in federal funding to proceed.

“Implementing the Affordable Care Act is one of my top priorities,” said DC Mayor Vincent Gray at a June 2012 press conference.

The DC plan includes a mandate that has drawn some controversy. All health-insurance plans sold in the city for 50 members or fewer must be purchased through the exchange.

A letter signed by a coalition of more than 150 DC-based small businesses and associations said the exchange mandate betrayed “President Obama’s repeated assurances that, ‘If you like your health plan . . . you will be able to keep your health care plan. Period,’ said Obama in championing the plan on the campaign trail.

Small businesses with less than 50 employees are not required to provide insurance for their employees under the plan and all small businesses can keep their existing insurance plans if they were in place before the health care law passed in 2010, but they must work through the exchange if they switch their plans or make significant changes in coverage.

A report prepared in 2011 for the DC Department of Health Care Finance said that in 2010 about 19,000 DC residents pur­chased individual health-insurance plans. The report also cited federal data from 2010 showing 7,300 District employers offered plans to 50 or fewer workers — about 125,000 employees in all.

“For the exchange to be sustainable, it has to have approximately 100,000 people,” Akhter said earlier.

“If the exchange isn’t sustainable in the long haul, if it does not have enough people, then we are wasting our time and our effort,” he added.

The HBX Board this week met another plan mandate with the announcement of the appointment of nine DC residents to its newly established Standing Advisory Board, from “…which the Board shall solicit recommendations, and consult on insurance standards, covered benefits, premiums, plan, technology system development, and any other policy or operational issues within the executive board’s discretion,” as stated in the establishing DC law.

An HBX press release Wednesday provided brief bios of members of the new advisory board:

“Karen Johnson has been with United Healthcare since 2007 and is currently the Executive Director of the United Healthcare Community Plan. Ms. Johnson is also a registered nurse and attorney, and has worked in variety of healthcare settings, gaining experience on both the payer and provider side of the Health care continuum. Ms. Johnson was chosen to satisfy category 4, commercial sector health plans, and was appointed for a 2-year term.

Barry Lewis has been an anesthesiologist at Washington Hospital Center since 2003, and was previously with Johns Hopkins and Sibley Hospitals. Dr. Lewis also serves as a Medical Board Executive for the D.C. Medical Society and as a member of the D.C. Health Information Exchange Board. He was chosen to satisfy category 1, health care professionals, and was appointed for a 2-year term.

Dania Palanker has been the Senior Health Policy Advisor for National Women’s Law Center since 2011. Ms. Palanker has been tracking the implementation of ACA and the establishment of health exchanges in particular on a professional basis since the passage of the legislation. She was chosen to satisfy category 3, demographic-specific advocacy groups, and was appointed for a 2-year term.

Billy MacCartee has been the President of MacCartee Medical Management, Inc. (First Financial Group) since 1996. As an insurance broker, Mr. MacCartee has over 200 corporate clients in the mid-Atlantic area. Mr. MacCartee was chosen to satisfy the mandatory requirement of having a broker (category 6) on the Standing Advisory Board and was appointed for a 3-year term.

Jill Thorpe is the general counsel for AFrame Digital, a health IT company providing remote monitoring solutions for seniors and patients with chronic conditions in home, senior living, and long term care settings. Through her profession, Ms. Thorpe has gained familiarity with the ACA generally and in particular with efforts to promote innovative models of care and payment. Ms. Thorpe was chosen to satisfy categories 2 and 9, health insurance and Exchange consumers, and was appointed for a 3-year term.

Kevin Dougherty has been an employee at the National Multiple Sclerosis Society, National Capital Chapter for over 19 years, serving as a Counselor, Care Manager, and Clinical Supervisor. Mr. Dougherty currently serves as Vice President of Programs and Services at the Chapter and his responsibilities include overseeing the development, delivery and evaluation of programs and services. Mr. Dougherty was chosen to satisfy category 3, disease-specific groups, and was appointed for a 3-year term.

Stephen Jefferson is a Stage-4 Hodgkin’s Lymphoma survivor, an active member and volunteer of the DC Cancer Consortium, and an active member of the Ward 8 Health Council. Mr. Jefferson is particularly interested in addressing healthcare disparities and the importance of primary care early detection and treatment compliant issues. Mr. Jefferson was chosen to satisfy categories 2 and 9, health insurance and Exchange consumers, and was appointed for a 4-year term.

Claire McAndrew is a Senior Health Policy Analyst at Families USA, a national non-profit, non-partisan organization dedicated to the achievement of high quality, affordable coverage for all. In that position, Ms. McAndrew tracks exchange establishment efforts nationwide and manages advocacy work on exchanges, both as it pertains to federal policymaking and to provide technical assistance to state-based advocacy organizations. Ms. McAndrew was chosen to satisfy category 7, health care consumer interest advocacy, and was appointed for a 4-year term.

Chris Gardiner is the founder of GKA, P.C., a minority-owned certified public accounting and management consulting firm domiciled in the District of Columbia and has served as its chairman for the past 25 years. Mr. Gardiner is currently a member of the Board of Directors of United Medical Center, the District of Columbia’s not-for-profit hospital corporation, and previously served on the Board of Directors of Howard University Hospital. Mr. Gardiner was chosen to satisfy categories 2 and 9, health insurance and Exchange consumers, and was appointed for a 4-year term as well as to serve as chairman of the Advisory Board.”


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