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New York moves to set up health-insurance exchange
A health-benefit exchange for New York State is back on the table, and it could change the insurance market for small businesses. But at this point, experts say it’s unclear exactly how. Gov. Andrew Cuomo included legislation in his 2012-13 proposed state budget that would set up a health-insurance exchange in New York. The exchange […]
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A health-benefit exchange for New York State is back on the table, and it could change the insurance market for small businesses. But at this point, experts say it’s unclear exactly how.
Gov. Andrew Cuomo included legislation in his 2012-13 proposed state budget that would set up a health-insurance exchange in New York. The exchange would meet requirements in the Patient Protection and Affordable Care Act, the 2010 federal health-care reform law.
While it has yet to be approved by legislators, attorneys say small businesses may want to keep an eye on it — even if they don’t currently provide insurance to their workers.
“Most small employers are pretty excited about it and should be tuned in,” says Kathleen Centolella, a partner at Syracuse–based Green & Seifter, Attorneys, PLLC which specializes in employee benefits. “It gives them a one-stop shop to potentially provide insurance when they haven’t in the past.”
The legislation in the governor’s budget is similar to health-insurance exchange legislation that stalled in the legislature last year, Centolella says. It is also similar to guidelines set forth by the federal Department of Health and Human Services.
In theory, the exchange could take some of the administrative burdens away from small businesses offering health care, according to Centolella. It could make it easier for employers to pick a level of health-care insurance they are willing to provide and give employees the choice to enroll in a plan, she says.
That’s because in addition to setting up a market for individual health insurance, the exchange legislation calls for setting up a Small Business Health Options Program (SHOP) to help employers enroll their employees in the group-insurance market. The governor’s budget proposal estimates the exchange would be completely funded by the federal government, extend health coverage to more than 1 million uninsured state residents, and reduce the cost of small-business health insurance by 22 percent.
The proposed exchange would set up five-member regional advisory committees for New York City, metropolitan suburban, northern, central, and western regions in the state. That could help the exchange meet needs in different areas, Centolella says.
“The fact that we have regional boards I think is one of the most important, unique aspects of New York’s exchange,” she says. “Because the market is different downstate than it is here. And the population is different.”
However, Centolella points out that it is too soon to know exactly how the exchange would work. The legislation leaves many components to be worked out in the future, she says.
“The devil is in the details,” she says. “I’ll be curious to see once the actual technology is created how it works and how it looks. Like anything that’s IT driven, if it doesn’t work well, you lose a lot of potential users. The last thing they need is something that’s complicated.”
Her caution was shared by Jill Muratori, vice president and counsel at Albany–based Barrett Associates and legislative representative for the Independent Insurance Agents & Brokers of New York, Inc. (IIABNY). IIABNY, based in DeWitt, is a not-for profit trade association of independent insurance professionals.
The proposed exchange legislation lacks many details and leaves much to be determined, Muratori says.
“Currently the legislation sets up a basic framework for this exchange to get up and running,” she says. “There are a lot of things on the to-do list for the people who are going to be on the [exchange’s] board of directors.”
IIABNY is pleased that the exchange will not cut insurance agents and brokers out of the health-insurance market, according to Muratori. They could be appointed to the exchange’s nine-member board of directors or sit on its five regional councils, and brokers and agents will still be able help consumers find insurance, she says.
Federal law requires the exchange to be up and running by 2014, so Muratori expects the proposal to be passed in New York this year, so the state can be prepared.
“There are a whole bunch of deadlines,” she says. “I really think [legislators] have to do something this session.”
Excellus reopening enrollment for two plans in Oswego County
Excellus BlueCross BlueShield will begin taking new members for its family Health Plus and HMOBlue Option plans in Oswego County starting Feb. 1. Excellus, which is Central New York’s largest health insurer, had stopped enrolling new members in those plans in recent years. It closed the plans to new enrollees in 2005 but continued to
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Excellus BlueCross BlueShield will begin taking new members for its family Health Plus and HMOBlue Option plans in Oswego County starting Feb. 1.
Excellus, which is Central New York’s largest health insurer, had stopped enrolling new members in those plans in recent years. It closed the plans to new enrollees in 2005 but continued to cover members who had signed up with the plans before that.
The insurer decided to sign up new members after a request from the New York State Department of Health, according to Sheila Betters, director of sales and marketing for safety net and state-government programs at Excellus. The state asked Excellus to renew its services in Oswego County after another insurer, Syracuse–based Total Care, Inc., decided to stop offering similar insurance in the county, she says.
“[The state] wanted to be able to keep a well-rounded set of options available to people in that community,” Betters says. “We’re happy to do it. It was something that had been discussed, so this was just a great way to make it happen.”
Family Health Plus is a state-sponsored, managed-care health-insurance program. It is aimed at adults 19 years old to 64 years old with incomes that are too high to qualify for Medicaid.
HMOBlue Option is Excellus’ Medicaid managed-care plan. It is for individuals who are eligible for Medicaid, although some people who receive Supplemental Security Income also qualify.
Members of the Excellus plans can choose from 9,000 doctors, specialists, and hospital providers throughout the insurer’s coverage area, which includes Central New York, Rochester, the Southern Tier, and Utica. The plans cover vital services, although co-pays sometimes apply.
Excellus decided to close enrollment in Family Health Plus and HMOBlue Option in 2005 to review the programs, according to Betters.
“We just decided to take a breather to make sure we had the structures that we wanted to have in place and the services available to support our membership,” she says. “It’s more about inner workings and everything that’s in place for membership.”
Excellus made no major changes to the plans now that they are being reopened in Oswego County, Betters says. Excellus will continue to review the programs and look for ways to improve them, she adds.
The health insurer expects to add about 3,500 Oswego County members to the two plans combined after enrollment opens Feb. 1. The new members will likely come quickly, Betters says, as individuals seek to maintain their health insurance while Total Care pulls out.
About 128,000 people are enrolled in Excellus HMOBlue Option plans throughout the insurer’s Utica, Rochester, Central New York, and Southern Tier regions. Another 21,000 are enrolled in Family Health Plus in those regions.
Excellus will not have to heavily advertise the opening of the programs to potential enrollees in Oswego County, Betters says. Local and state-government agencies typically help eligible individuals enroll in the programs, she says.
“There’s a natural flow of information,” Betters says. “They would help with the enrollment to any of the plans.”
Excellus BlueCross BlueShield is a not-for-profit independent licensee of the BlueCross BlueShield Association. The insurer is headquartered in Rochester and bases its Central New York operations in Syracuse.
Greek Peak must find new lender following bank closure
VIRGIL — Greek Peak Mountain Resort must refinance several loans after regulators shut down its lender, Nashville–based Tennessee Commerce Bank, last week. Loans made to
Deconstructing the American Dream
I want to thank President Barack Obama for delivering his third “State of the Union” address, in which the 44th president of the United States laid out clearly his vision of the American Dream.The president embraces 100 years of “progressivism,” which rejects a free-market society. Today, we call progressivism “liberalism,” not to be confused with
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I want to thank President Barack Obama for delivering his third “State of the Union” address, in which the 44th president of the United States laid out clearly his vision of the American Dream.
The president embraces 100 years of “progressivism,” which rejects a free-market society. Today, we call progressivism “liberalism,” not to be confused with classic 19th-century liberalism. Liberalism considers capitalism inherently evil, requiring a strong, central government to rein in its “excesses.” Thus, the federal government needs to actively regulate the economy by assigning technocrats who know what is best both for the collective society and for individuals. Those technocrats who are truly knowledgeable know better than the marketplace where capital should be invested and which industries must be supported.
Government, not the individual, must also be the protector against anything unfortunate in our lives, advocates of liberalism believe. To institute freedom from want, society needs universal child care and health care, higher education for all, welfare benefits for the less fortunate, labor protection, agencies to manipulate the boom-and-bust cycles, and pensions for the elderly.
President Obama wraps his dream of America in a cloak of fairness. He casts himself in the populist role as the defender of the middle class, which is being squeezed by the rapaciousness of the 1 percent who are super rich. To the current sitting president, free enterprise has eroded the basic American promise of opportunity. In the words of the president, the defining issue is to “… restore an economy where everyone gets a fair shot, everyone does their fair share, and everyone plays by the same set of rules.”
From whence floweth fairness? From the federal government, of course. The president, in his speech, cited the “Buffett Rule” as a prime example of fairness. No one deemed rich by the president should pay a lower rate of federal-income tax than Warren Buffett’s secretary.
Kudos to the president for explaining his vision of America for all to understand.
Mitch Daniels, governor of Indiana, rebutted the president’s vision with a strong defense of free enterprise and capitalism. Daniels chided the president for assuming the state of the economy was strong and getting stronger while the unemployment rate remains stubbornly high and our spending and indebtedness are on a trajectory to take down the economy and the safety nets created by government. He also debunked the notion that government could create a middle class of government workers based on borrowed money.
Unlike the president, the governor called for a passionate, pro-growth approach that generates private-sector jobs. Unlike President Obama, Gov. Daniels praised business rather than bashed it and called for a simpler tax code with fewer loopholes and lower rates and an end to the piling on of expensive, new regulations. Unlike the president, he sought a unity of effort rather than a division pitting one segment of society against another.
The differences in the two visions couldn’t have been clearer. Too bad Messrs. Romney and Gingrich couldn’t build on Daniel’s rebuttal; unfortunately, they were too busy punching each other rhetorically in the groin. Gov. Romney did finally, under duress, release his 2010 federal-tax return and his projected 2011 return. News flash: The governor is rich.
What a perfect opportunity to defend a life of hard work and taking risks creating and turning around businesses — the ultimate American dream. What a perfect opportunity to attack the current tax code as convoluted and anti-growth, explaining that capital-gains taxes are added to the corporate tax, generating an effective rate of 44.75 percent before adding on state, local, and any estate taxes. Too bad the opportunity was lost as the former governor of Massachusetts continued to focus on hammering the former Speaker of the House. And to Mr. Gingrich’s eternal discredit, too bad he suggested that Romney’s wealth was somehow ill-gotten rather than focusing on the vision of a “city on the hill.”
I have experienced free enterprise from the perspective of an entrepreneur. Next year is my 50th year running a business in our region, and this past year marked 25 years of interviewing thousands of business owners, managers, entrepreneurs, and wannabes as the publisher of The Business Journal. I have witnessed how an individual with a dream takes risks by applying his/her God-given talents in the hope of experiencing success. The best arbiter of success is the marketplace, where individuals freely decide what constitutes the pursuit of happiness. The ladder of opportunity has, despite the president’s assertions, drawn the diminishing middle class into the ranks of the rich. In the past 30 years, the percentage of households making more than $105,000 in inflation-adjusted income has more than doubled from 11 percent to 24 percent.
Unlike President Obama, I find those running a business to be society’s heroes, deserving of praise, not opprobrium. They not only create wealth for all in our society, but they also give back generously to enhance our communities. What is most surprising is that they accomplish this under a growing burden of taxation, regulation, and a playing field where the goals posts are always in motion. Contrary to liberalism’s assumptions, capitalism is not dehumanizing. Personally, I find it to be uplifting.
De Tocqueville told us that democracy extends the sphere of individual freedom; it attaches all possible values to each person. Progressivism, 21st-century liberalism, collectivism, statism — whatever you call it — makes each of us an agent, a number in a society where others tell us what is best. Both concepts claim to seek equality in liberty: capitalism promotes freedom from coercion, liberalism relies on coercion and restraint.
To me, the president’s State of the Union address deconstructs the American Dream that has made the United States an exceptional nation and the beacon to the world. It’s critical to point out that he is tearing down the ladder of opportunity by promoting a society in which risk is not rewarded. We have a clear choice to make about what kind of society we want.
I cast my vote for capitalism and a society in which the individual has the maximum freedom to make a choice. I vote for a strong, pro-growth agenda where the marketplace, not government, picks winners and losers. I vote for a simple and predictable tax system and government benefits that are means-tested. I vote to create more successful business people to join the 1 percent castigated as the super-rich. I believe in a restrained government, not one on the path to fiscal obesity.
It’s time to reconstruct the dream. It’s time to cast your vote.
Norman Poltenson is publisher of The Central New York Business Journal. Contact him at npoltenson@cnybj.com
Comptroller: Recovery seems to be weakening in New York
New York state’s economic recovery may be slowing, according to a report released this morning by Comptroller Thomas DiNapoli. The state lost 11,200 private-sector jobs
Upstate consumer confidence rises again in January
Consumer confidence increased for the third straight month in upstate New York in January as consumers indicated a growing willingness to spend under current conditions.
Oneida Financial Q4 profit rises nearly 11 percent
ONEIDA — Oneida Financial Corp. (NASDAQ: ONFC), parent company of Oneida Savings Bank, reported that its fourth-quarter profit rose almost 11 percent as net interest
New York dairy farmers receive lower prices for milk in January
Dairy farmers in the Empire State received an average of $20.30 per hundredweight of milk sold during January, down 40 cents from December, but still
Venture event seeks applicants
The 2012 Venture Forum, a partnership between the Center for Economic Growth (CEG) SmartStart UNYTECH program and Western New York’s Bright Forum, is looking for
St. Joseph’s ready to open emergency services building
SYRACUSE — St. Joseph’s Hospital Health Center prepared to open a new emergency services building by holding a ribbon cutting and blessing ceremony this morning.
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