2011 — May 16
Health Care For All New York testimony to the New York State Department of Insurance on the Establishment of a Health Insurance Exchange in New York State
HCFANY urges the New York Legislature to adopt Exchange Legislation during the 2011 Session, which ends on June 20, 2011. Several key governance issues must be addressed in this bill, including: whether the Exchange should be run by a government agency or nonprofit; who should serve on the Exchange board; and how the Exchange should be funded.
The Legislature should establish a government-run Exchange. A not-for-profit entity will not have governmental accountability or transparency and would not be trusted by the general public with making adjudicatory decisions or handling confidential information. While HCFANY would be comfortable with either an Exchange housed in an existing governmental department or a public authority, it appears that a public authority does have some significant advantages, including enhanced flexibility in procurement and other rules, singularity of mission, and freedom from conflict of interest between regulatory and contracting roles.
HCFANY urges the Legislature to adopt a Board governance model in which the Board has seven members, appointed by the Governor, upon advice and consent of the Legislature. We believe the ideal Exchange Board would have three Ex Officio Members: the Superintendent of Insurance, Commissioner of Health, and Medicaid Director; and three to four members who represent the fiduciary interests of consumer and employer purchasers and who have demonstrated knowledge and expertise in matters such as insurance coverage, public health, and health care finance . The non-governmental members of the Board should: reflect diversity of expertise; reflect the gender, racial and ethnic and geographical diversity of the State; and not have any conflict of interest. In addition, the Board should establish an advisory committee that represents the views and knowledge of interested parties who might be precluded from Board service by their conflicts of interest and to more fully represent the diverse interests of New York’s stakeholders.
Finally, the Exchange should be funded through a universal method of assessment/taxation. The Exchange will be performing governmental functions which benefit the entire state, and it would be counterproductive to burden only products in the Exchange with the costs of performing those functions. The Exchange must be generously funded to be effective in its role.