Monday, December 10, 2012

What a Tangled Web We Weave . . .

Ah yes. Those pesky health insurance exchanges. So far only 17 states have agreed to set up their own exchange. Six have indicated they will enter into a partnership with the feds, which basically means the feds will fund it, make the rules and let the states run it for them.

The rest have not yet declared or have emphatically stated they don't want any part of the exchange.

So what's the big deal?

Well it seems there might be a "connection" between HHS Sec. Sebelius and the software company that will be used for the federal exchanges.
in January, HHS awarded Quality Software Services, Inc. (QSSI) what the Hill describes as “a large contract to build a federal data services hub to help run the complex federal health insurance exchange.” At that time, the director of Obamacare’s newly established Center for Consumer Information and Insurance Oversight (CCIIO) — which the Hill describes as “the office tasked with crafting rules for the national exchange” — was Steve Larsen. Larsen had been the insurance commissioner for Maryland when Obama’s HHS secretary, Kathleen Sebelius, was the insurance commissioner for Kansas, and the two are reportedly close. The CCIIO awarded the Obamacare exchange contract to QSSI while Larsen was the CCIIO’s director, and he played a central role in planning the construction of the exchanges — although it’s not known whether he made the decision to award the contract to QSSI or not.
Weekly Standard

The plot thickens.

Under the contract that it signed with HHS, QSSI’s power would be substantial — as QSSI would shape, run, and affect companies’ ability to compete to sell insurance through Obamacare’s federal exchanges. The Hill writes, “A draft statement of work for the contract awarded to QSSI states the contractor should provide services necessary to acquire, certify and decertify health plans offered on a federal exchange.” Moreover, “It stipulates the contractor should monitor agreements with health plans, ensure compliance with federal standards and” — somewhat strikingly — “take corrective action when necessary.”
QSSI, apparently realizing what a valuable asset it had in the contract, started shopping itself around. Meanwhile, Larsen left the CCIIO and took a highly paid position with Optum, a subsidiary of UnitedHealth Group, in June. Sometime this summer, UnitedHealth Group bought QSSI.
So why is the Obama administration willing to allow an insurance carrier (UHC) to run an exchange? Does this not give that carrier an unfair advantage in a "free" market place?

And what about all the health data that will be gathered on private citizens. It's bad enough that every doctor visit, lab test, etc is reported to HHS but at least some of this data will also be captured by a subsidiary of UHC.

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