Feds Require Changes to Virginia Health Insurance Law
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10 responses to “Feds Require Changes to Virginia Health Insurance Law”
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Not hard to understand. The ACA established standards of coverage for plans and federal dollars may cover some portion of premium and expenses associated with those plans sold on the MarketPlace.
If the State mandates a coverage, it can’t discriminate based on how the plan is sold, and if it costs more for plans on the MarketPlace, the State must cover its share of that increase.
Of course, the beauty of that notion is that its in the tax codes and, well, we all know what SCOTUS said of that.
Kind of surprising that the crafters of the laws in question didn’t evaluate those changes.
BTW, having worked tangentially in the government where one comes across a certain level of head scratching almost daily, one thing really bothers me. Shouldn’t it be CMMS.gov?
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Good analysis. See my response to Dick below about Virginia’s law- and rule-making process.
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Thank you. It was a spec job. “Don’t ‘spect much.”
Unlike most of the BR persuasion, I love the ACA. It’s a wonderfully simple dovetail of the Schedule A medical deduction with a premium credit that saved the private medical system. It was 10,000 pages with 9,999 of it a waste of paper. That’s it. That’s all it is. Well, a lot of bitchin’ and screamin’, but simple.
I could sum up the entire ACA in one page with examples.
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Nice reporting, Jim. This is a complicated area. I don’t mind admitting that I did not understand much of what you reported.
If anyone is to blame, it would be the SCC and its Bureau of Insurance. The bill gave the SCC the duty to implement the new exchange and SCC staff normally follow bills that affect that entity. They should have alerted the GA of the conflict with federal law.
It will be interesting to see what happens next Session, when someone tries to clean it up. The state law authorizes the establishment of a state health exchange, which, I presume, Virginians can use to utilize Obamacare. Now, Republicans hate Obamacare and the vote on the bill in 2020 was a straight party line vote in the House of Delegates. I wonder if the House Republicans, who will be in the majority (I assume) in 2022, will agree to get rid of a conflict with federal law in the Virginia Code.
Am I correct in interpreting your explanation as meaning that the state will have to pay penalties if it does change its law to conform with federal law?
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Thanks and you are correct.
As a strategic observation, I have noted over the years that Virginia laws and regulations have thousands of more pages than necessary because they attempt to restate issues that are covered by federal law and regulation.
That is a double- pronged mistake. It is not only a great waste of effort, but always exposes those laws and regulations to the supremacy clause as here and risks them being made obsolescent at the stroke of a federal pen.
Healthcare is one of the clearest areas of vast federal control. Virginia law and regulations, in my view, should incorporate by reference any controlling federal laws and regulations using “and successors” to cover changes. Then scrupulously avoid attempting to restate what those federal guidelines are. If the federal laws require states to set various implementing policies, then do so. Otherwise, leave it alone.
Virginia obviously needs its own laws and regulations, but lawmakers and rule makers make it way harder and riskier than it needs to be when the federal government has laws and policy that will preempt Virginia rules.
I have made this argument before with reference to Virginia’s very extensive laws and regulations on nursing home requirements and inspections. The federal government has a complete set, and Virginia Department of Health inspectors actually conduct the inspections under federal rules. There are only six nursing homes in Virginia that are not CMS certified. Virginia DOH also insects those, but under Virginia rules.
So Virginia takes up a very large section of the legal and administrative codes writing its own rules for nursing homes rather than just adopting the federal guidelines by reference.
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You’re right about one sure thing “Don’t duplicate the Federal law. Cite it, and add the State addendum.”
Still, shouldn’t it be CMMS? Fix the small stuff first.
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Literally thousands of pages of state law and regulations are at best redundant.
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Department of Redundancy Department
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