Reform policy news: High-risk pools, exchanges, IPAB

News outlets are reporting on various aspects of the health law, including the low level of interest seen so far in high-risk pools, the varying reactions states are having as they make decisions about health insurance exchanges and the ongoing efforts to repeal the measure's Independent Payment Advisory Board.

Marketplace (public radio): Not Enough People Dive Into High-Risk Pools
The insurance exchanges for people with preexisting conditions aren't living up to expectations. And politics plays a part. ... High-risk pools [are] insurance pools meant for people with pre-existing conditions who are considered high-risk. Another way to say that is sick people who insurance companies usually try to turn away. The health care law set aside $5 billion to help those folks. But one year later, few people are taking that help (Warner, 4/25).

Politico Pro: Utah Exchange: Low-Cost Model Or Loss Leader?
Utah likes to tout the leanness of its health exchange, a free-market establishment that the state says runs on the shoestring budget of $500,000 — a particularly remarkable number compared to the $40 million budget of the Massachusetts exchange. But Utah's feat is less impressive when you consider this: the main Utah health exchange vendor has operated at a loss on the contract. "We're not that far away from this being profitable," says Rich Gallun, CEO of health technology vendor bswift, which has the largest contract with the Utah exchange. "As long as the state of Utah was committed, that opportunity in itself would make the investment worthwhile. Beyond that, if we can help make Utah a success, we're confident that other states will follow" (Kliff, 4/26).

CQ HealthBeat: States Say 'Yes' and 'No' to Insurance Exchange Creation
Lawmakers from two states enacted laws in recent days that show their hands on the matter of health exchanges, moves that reflect the sharp divide nationwide on how to deal with that provision of the health law. Washington state lawmakers, on the one hand, passed legislation that pushes ahead exchange implementation under the dictates of the law. But Georgia Gov. Nathan Deal signed a measure that in theory would allow the state to refuse to create an exchange under the overhaul (Reichard, 4/25).

Denver Post: Health-Insurance Exchange Bill Gets Initial OK In Senate
The Democratic-controlled Senate on Monday overcame Republican objections to give initial approval to a bill that would create health-insurance exchanges. Senate Bill 200 has had a strange journey since being introduced by the bipartisan team of Sen. Betty Boyd, D-Lakewood, and House Majority Leader Amy Stephens, R-Monument. Facing Tea Party pressure over federal health care reform, Stephens at one point was supporting an amendment that backers of the bill said would kill it. She later backed off proposing the amendment in committee amid complaints from business groups, who overwhelmingly support the bill (Hoover, 4/26).

The Connecticut Mirror: Health Care Reform Draws Thin Crowd With Broad Concerns
The crowd wasn't big, but the first public forum on the health insurance exchange, a key piece of federal health reform, drew a range of perspectives from the 17 people who showed up. ... They didn't get concrete answers; ... many answers don't exist yet. The state is at the beginning of a multiyear planning process to build the marketplace for purchasing health care coverage (Levin Becker, 4/26).

CQ HealthBeat: Business Groups Urge IPAB Repeal
A coalition dominated by business groups sent a letter to Rep. Phil Roe, R-Tenn., on Monday endorsing his legislation to eliminate the Independent Payment Advisory Board. "IPAB" is a key element of President Obama's plan to reduce Medicare spending growth and to trim deficit spending. Under the health care law, starting in 2014, IPAB will have the power to issue recommendations to reduce Medicare spending if it exceeds certain levels. Congress can block the board's recommendations from taking effect, but it is not easy for lawmakers to do so (Reichard, 4/25).