Commissioner Goodwin leads on Health Marketplace debate

Today NC Blue Cross’ bill (H115) on the health insurance marketplace/exchange was brought up in the House Health Committee and was hit with a major downshift in speed and a significant improvement in debate.  Leading the charge for individuals and small businesses in the packed committee room was NC’s Insurance Commissioner Wayne Goodwin.

Goodwin presented to the committee the outline of a potential compromise proposal on governing the new NC Health Marketplace.  Rather than allowing insurers on the board of the marketplace, Goodwin’s idea is to have a core board of experts in health care economics, markets and policy – all without financial conflicts of interest (like working for a health insurance company).  He would then set up several official board advisory committees to the Marketplace:  one of insurers, one of providers, one of consumers, one of businesses, etc., who would all offer their expertise to the board through individual ex-officio non-voting members.

From the consumer advocacy perspective, this is an interesting step.  The devil is always in the details, but Goodwin’s leadership in suggesting reasonable ideas for compromise is a very positive development.  Clearly the Commissioner has been listening to all points of view on the contentious issue of governance of the Marketplace and is proposing a way forward.

Of course, the details of what ability the Marketplace will have to offer consumers a real choice of competing health plans – and not just a “pick which Blue Cross plan you like the most” option is another important detail that only started to receive discussion in the committee.  Representative Verla Insko – sponsor of the Institute of Medicine compromise bill on the marketplace –  and Representative Jennifer Weiss  began to highlight the importance of that issue in the committee and will clearly be in the lead in making sure any new marketplace actually works for consumers.

The other significant development in the committee was the acknowledgment by many members of the legislature that the health care marketplace issue is the most significant piece of health care legislation to be considered this year.  Therefore, Representative Dollar, Chair of the Health Committee, announced that they would take time to work on the legislation and that it would not come up for at least another two weeks.  This is a big change from the previous fast track Blue Cross’ bill had been on.

Is there hope for creating a decent Health Marketplace in NC that isn’t dominated by NC Blue Cross?  We’ll see, but right now things are starting to perhaps move in the right direction.  Stay tuned.

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Commissioner Goodwin leads on Health Marketplace debate