Article   |   Volume 159, Issue 6

Reflections on the National Association of Insurance Commissioners and the Implementation of the Patient Protection And Affordable Care Act

By
Timothy Stoltzfus Jost

June 2011










One of the most common criticisms of the Patient Protection and Affordable Care Act (PPACA) is that it constitutes a government takeover of America’s health care system. By this, of course, is meant a federal government takeover. PPACA will certainly increase the federal government’s presence in health care. It imposes new federal regulations on insurers, creates a new federal program for funding health insurance for uninsured middle-income Americans, dramatically expands the Medicaid program, and in all likelihood will increase the influence of the Medicare program on the organization of the overall health care delivery system.

Yet PPACA also expands the responsibility and authority of the states. The states, for example, are primarily responsible for enforcing PPACA’s insurance regulatory reforms. They are also responsible for establishing the exchanges—the entities through which Americans will purchase insurance and apply for subsidies—and for managing reinsurance and risk adjustment programs. According to the Act, states will be responsible for reviewing health insurance premiums and for assisting consumers with complaints against their insurers.

However, PPACA not only increases the authority of the federal and state governments, it also empowers and assigns significant responsibility to a private agency: the National Association of Insurance Commissioners (NAIC). The NAIC is a private, nonprofit organization that has coordinated the activities of the nation’s state and territorial insurance commissioners since 1871. Its members are the insurance commissioners of the states and territories. Traditionally, the NAIC has drafted model statutes and regulations for the states, served as a clearinghouse for insurance data, and provided a forum for insurance commissioners to discuss and address regulatory issues. Reflections on the National Association of Insurance Commissioners and the Implementation of the Patient Protection And Affordable Care Act - PennLawReview.com


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