Barbara Pinckney writes in the Business Review (subscription-based) - “It brought $64,000 to Albany International Corp., $400,000 to KeyCorp and millions to other area employers.

But now the clock is ticking on the Early Retiree Reimbursement Program.
“The program is not even a year old and it’s maxed out,” said Maggie Moree, director of federal affairs for the Business Council of New York State.

The ERRP was established under the federal health care reform act to help employers provide coverage for workers who retired after age 55 but before they were old enough for Medicare.”

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Cara Matthews writes on pressconnects.com - “Two years and eight months may seem like a long time, but state officials will have to work diligently in order to make the January 2014 deadline to set up the health-insurance exchange required under federal law, advocates said Friday.

Under the health care reform law passed by Congress and signed by the president, Americans have to obtain health insurance by Jan. 1, 2014 or face a fine. Each state has to set up an exchange, essentially a marketplace where individuals and small businesses will go to choose a plan.

Some advocates said it’s critical for lawmakers to pass legislation by the end of the session in June.”

To read more click here.

A little over a year ago, as Congress was debating how to reform health care delivery in this country, an idea that seemed simple enough was
to create new marketplaces, called “exchanges,” where consumers can comparison shop for health insurance. As with many other aspects of implementing the health overhaul law, state-based insurance “exchanges” offer both opportunity and challenge to states, as they grapple first with the decision on whether they want a state-based exchange, or whether they wish to cede this process and market to a federal exchange.

Some states like California have already passed legislation to establish the structure for their state-based exchange. At least one state- Louisiana – has decided not to establish a state-based exchange.  Most states, including New York, are now just focusing on how best to implement an exchange and what changes in state law are needed to make that happen. These changes need to occur this legislative session to enable New York to access federal grants made available to help offset the cost of implementation, and The Business Council will be advocating for an exchange model that puts small business as its primary customer.

If done well, proponents say, exchanges could make it easier to compare, buy and enroll in health insurance. But, if designed poorly, experts warn, healthy people could avoid the exchanges, leaving them to sicker people with rising
premiums. Some key issues The Business Council will be asking the legislature to consider as they proceed with setting up the model for NY’s Exchange:

• The State should not be both regulator and exchange operator. The Insurance Department should continue in its role of regulating health insurance plans and monitoring premiums and should be promoting competition through a broad choice of plans within the exchange. There are private industry models that provide exchange-like functions currently and these models should be more closely examined to see how they could be leveraged to meet the state’s objectives.

• Do not use a “Field of Dreams” approach and build a one-size fits all model. The State has a checkered history in getting large, complex systems designed and functioning on time and on-budget. In this instance, The Business Council believes the federal intent was to provide a marketplace for individuals and small businesses to compare and purchase health insurance. With experience and data, a case might be made for integrating systems, which perform eligibility for entitlement and subsidized programs such as Medicaid, but we support as a starting point establishing a Small Business Health Options Program – a SHOP Exchange – as permitted by federal law. Once functioning and operational, how integrating administrative functions and other populations can be achieved across systems can be more thoroughly evaluated.

• Guided customer choice is key. No one would argue that purchasing health insurance is akin to purchasing a hotel room or airline ticket. There is a role in this process for agents and brokers and others such as chambers of commerce who help small businesses navigate the complicated world of employee benefits. While an exchange can serve as a portal for comparing products, helping to understand which product may best meet your needs is far more specialized.

• Flexibility on plan design is important. Once the federal regulations establish the essential benefit package, the role of the Exchange should be to approve all those plans, which meet those standards to be made available through the Exchange. The Exchange operator should not limit plan design as long as it meets those minimum standards. Without that flexibility, small businesses may find that the plans within the Exchange do not offer what they need and the value for employers and their employees will be greatly diminished.

The Business Council has arranged for state Senator James Seward (R- Oneonta), chairman of the chamber’s Insurance Committee, to address Business Council members on May 4.

According to Business Council member Crain’s New York (subscription based) - “The Cuomo administration holds its first stakeholder meeting on the federally mandated health insurance exchange today. If the Business Council of New York State gets its wish, the exchange will be market-based rather than grounded on a Medicaid foundation. The group also wants businesses to be able to comparison shop for health insurance in and outside of the exchange, said Maggie Moree, the group’s director of federal affairs.

The law’s intent is to provide a marketplace for individuals and small businesses to compare and buy health insurance. But the Business Council said the state should not create one exchange that serves the individual, small business and Medicaid markets. In time, a case could be made for integrating systems that determine “eligibility for entitlement and subsidized programs such as Medicaid,” said Ms. Moree, but for now, the Business Council advocates a Small Business Health Options Program exchange for small businesses. It says the state can focus on integrating administrative functions and other populations when the SHOP is operational.

The group also doesn’t want the state to be the exchange’s regulator as well as its operator, which acts as an insurance purchaser. The Department of Insurance should continue as regulator, it says, adding that private models could be adapted to meet the state’s objectives for the exchange.

The group has been lobbying the Legislature to adopt those positions. It has also arranged for state Senator James Seward (R- Oneonta), chairman of the chamber’s Insurance Committee, to address Business Council members on May 4.

The following posting is by Thomas J. Donohue, President and CEO of the U.S. Chamber of Commerce.

“The nation’s infrastructure—the lifeblood of our economy—is in rapid decline, the victim of underinvestment. A 2008 report estimated that the United States needs to invest $250 billion annually for the next 50 years to legitimately meet only surface transportation needs. We’re nowhere near that level of investment.

There are dire economic consequences for staying on our present course. Last fall, the Chamber released a study showing that the status quo in transportation infrastructure effectiveness over the next five years will result in the equivalent of $336 billion in lost economic growth.

Why are we falling behind? Because traditional public infrastructure funding mechanisms are inadequate for meeting the growing needs of our economy, businesses, and citizens. Receipts to the Highway Trust Fund have fallen substantially due to improved gas mileage and a federal gas tax that hasn’t moved in 18 years. Other traditional funding mechanisms, such as appropriations and municipal bonds, are being squeezed by the economic slowdown.

A comprehensive, multiyear highway and transit bill is long overdue, but it alone is not sufficient. Private investment must play a bigger role.

We can spur private investment by expanding and improving the Transportation Infrastructure Finance and Innovation Act (TIFIA), which provides federal credit assistance to nationally or regionally significant surface transportation projects. TIFIA is designed to fill market gaps and leverage substantial private co-investment by providing projects with supplemental or subordinate debt.

However, TIFIA’s reach is restricted to surface transportation projects. We need a similar financing mechanism to address our energy and water infrastructure needs. The answer is a new national infrastructure bank that would issue loans and loan guarantees for a broad array of infrastructure projects. With a modest initial investment of $10 billion, a national infrastructure bank could leverage up to $600 billion in private investments from global pension funds, private equity funds, mutual funds, and sovereign wealth funds.”

The Business Council of New York State is a proud member of the U.S. Chamber of Commerce.

An infrastructure bank would also keep politics out of the equation. Careful procedures have been established to ensure that projects receiving loans or loan guarantees are based on merit and are of national or regional significance. The bank would be run transparently by experienced professionals under congressional oversight and would include checks and balances to prevent abuse.

Our infrastructure challenge requires fresh, new thinking. A reinvigorated TIFIA program and a new national infrastructure bank would keep and attract vast amounts of capital in our country, help us compete worldwide, and put thousands of Americans to work.”

The Washington Post reports -  “The White House pressed ahead Wednesday with its campaign to enlist the support of corporate America, with two senior officials urging top business executives to sign on to the Obama administration’s plans for regulating Wall Street and laying the foundation for future economic growth.

The administration dispatched Gene Sperling, director of the National Economic Council, and Elizabeth Warren, President Obama’s pick to set up the new Consumer Financial Protection Bureau, to address the U.S. Chamber of Commerce, which has opposed many of the White House’s initiatives on the economy.”

To read more click here.

Politico.com reports - “Health care lobbyists and advocates are bracing for six pages of the health care reform law to explode into more than 1,000 pages of federal regulations when the Department of Health and Human Services releases its long-delayed accountable care organization rules this week.

“What, you expected less than a thousand pages for legislation that only took a page and half?” a staffer with one of the current proto-ACOs asked.”

To read more click here.

Regulators Move to Specify Coverage Under Health Law; Insurers Seek Flexibility

“The next big issue for the federal health law as it moves toward implementation is how regulators will define so-called essential benefits—the basic medical services that health plans must cover under the law.

The legislation gives 10 categories of care that plans must provide for customers of the health-insurance exchanges that are launching in 2014. But the law leaves details up to regulators, who are now starting to develop the rules,” writes Avery Johnson in the Wall Street Journal (subscription-based).

To read more click here.

Robert Pear writes in the New York Times -”The Obama administration said Wednesday that it had granted broad waivers to four states allowing health insurance companies to continue offering less generous benefits than they would otherwise be required to provide this year under the new federal health care law.

he states are Florida, New Jersey, Ohio and Tennessee, the administration told Congress.

Lawmakers said that many other states, insurers and employers needed similar exemptions from some of the law’s requirements and would seek waivers if they knew of the option.”

To read more click here.

Dana Milbank writes in the Washington Post about the out-spoken Governor of New Jersey and his recent trip to Washington, as well as his leadership style.

“New Jersey Republican Gov. Chris Christie’s first big speech in Washington was titled, “It’s Time to Do the Big Things,” and, sure enough, it didn’t take him long to make a fat joke.

Recalling that his predecessor, Democrat Jon Corzine, slept on a cot in the office when the state government shut down, Christie said he issued a warning to state legislators.

“I’m not moving any cot into this office,” the fast-talking governor said in his north Jersey dialect. “You close down the government, I’m gettin’ in those black SUVs with the troopers, I’m goin’ to the governor’s residence, gonna go upstairs, gonna open a beer, gonna order a pizza, I’m gonna watch the Mets. And when you decide to reopen the government, gimme a call, and I’ll come back, but don’t think I’m sleepin’ on some cot. Take a look at me. You think I’m sleepin’ on a cot? Not happenin’.”

“”The president’s not talking about it because he’s waiting for the Republicans to talk about it,” Christie said. “And our new, bold Republicans that we just sent to the House of Representatives? They’re not talking about it because they’re waiting for him to talk about it.”

Christie, however, is talking about it. “You’re going to have to raise the retirement age for Social Security,” he said. “Whoa-ho! I just said it, and I’m still standing here. I did not vaporize into the carpeting, and I said it.”

To read more click here.