Health law implementation: State insurance exchange bills; HHS rules on MLR Waiver requests

States are grappling to implement aspects of the Affordable Care Act.

Minneapolis Star Tribune: Bipartisan House Bill Outlines State Health Insurance Exchange
In a rare display of bipartisanship, three powerful Republican House committee chairmen have signed on to a DFL bill to establish a health insurance exchange for Minnesota, a required but controversial piece of the Obama administration's health care law. … While still lacking much detail, the bill begins to "put some meat on the bones" of a recommendation earlier this month by a task force appointed by Gov. Mark Dayton. It would be enough to meet a year-end federal deadline to show that Minnesota can have an exchange in operation by 2014, he said (Warren Wolfe, 2/16).

(St. Paul) Pioneer Press: At The Capitol: Health Care Exchange Bill Faces Long Odds
[The bill] featured bipartisan support in the form of co-sponsorship from Rep. Greg Davids, R-Preston, and two other Republicans. But Davids was clear in saying he thinks the federal legislation is a "scourge," adding that he hopes it will be overturned this year by the U.S. Supreme Court. More broadly, Davids said he wasn't aware of any broad change of heart among Republicans who last year blocked legislation on the subject (Snowbeck, 2/16).

The Atlanta Journal-Constitution: Legislators Seek Action On Georgia Insurance Exchange
Sen. Nan Orrock, D-Atlanta, and Rep. Pat Gardner, D-Atlanta, urged the General Assembly on Thursday to take action on legislation (House Bill 801 and Senate Bill 418) that would establish a new health insurance marketplace in Georgia. … Gov. Nathan Deal has said he doesn't want Georgia to move forward with planning for a state-based exchange until the Supreme Court decides whether the health law is constitutional. But Orrock and Gardner said Georgians need the marketplace now (Teegardin, 2/16).

CQ HealthBeat: Health Officials Deny Wisconsin Medical Loss Ratio Waiver Request, Give North Carolina Partial Reprieve
Federal health officials on Thursday denied Wisconsin's request for a waiver from a health care law requirement that insurers spend 80 percent of premium dollars on benefits. They required North Carolina insurers to meet that threshold beginning this year, but said that those who paid out at least 75 percent of premiums last year won't be penalized (Adams, 2/16).

Milwaukee Journal Sentinel: U.S. Rejects Waiver For State On Health Insurer Rule
The Obama administration has rejected Wisconsin's request to exempt health insurers from a new federal requirement that they spend 80 cents of every dollar in premiums on medical care. ... The Office of the Commissioner of Insurance contended the requirement could force companies to leave the Wisconsin market, potentially harming consumers. The U.S. Department of Health and Human Services found that the state did not provide data to support that contention (Boulton, 2/16).

Stateline: Illinois Tightens Medicaid Without Federal Approval
The 2010 federal health law has a so-called "maintenance of effort" requirement, which expressly prohibits states from doing anything that would reduce the number of people who qualify for Medicaid. But it's not clear whether the ban includes measures aimed at winnowing out people whose incomes are too high or who don't actually live within the state's borders (Vestal, 2/17).

California Healthline: Sharp's Pioneering ACO May Raise Bar in San Diego
Sharp HealthCare's selection as the only San Diego-based provider and one of six in California to participate in the federal Pioneer Accountable Care Organization program could raise the bar for health care providers throughout San Diego County. Through ACOs, a central feature of the Affordable Care Act, health care providers receive financial incentives to team up to provide higher-quality and lower-cost care to Medicare beneficiaries (Zamosky, 2/16).