Legislative Update October 12, 2011 Kristin Leighty, Government Affairs Coordinator, NAHU

1. Legislative Update October 12, 2011 Kristin Leighty, Government Affairs Coordinator, NAHU

2. NAHU Government Affairs team Laurel Call, Sr. Vice President and Counsel – Region 6 lcall@nahu.org 703.276.3801 Jessica Waltman, Sr. VP of Government Affairs – Region 2 jwaltman@nahu.org 703.276.3817 Pam Mitroff, Director of State Affairs – Illinois, Regions 4, 7 and 8 pmitroff@nahu.org 703.276.3839 Brooke Bell, Director of State Affairs – Region 1, 3 & 5 bbell@nahu.org 703.276.3818 Kristin Leighty, Government Affairs Coordinator kleighty@nahu.org 703.276.3803

3. Exchange Developments • Deadline Postponed for Proposed Regulation Comments • October 31 deadline for comment submission now • NAHU is finalizing comments and will be sending to HHS shortly • HHS Wraps Up Six-City Exchange Listening Tour • Exchange Level One and Level Two Grants • HHS Unveils “Partnership” Options • Federal fallback exchange framework unveiled – “Affordable Insurance Exchange Partnership Options Initiative” with three partnership options: • State Plan Management • State Consumer Assistance • Both Plan Management and Consumer Assistance • HHS Announces Federal Exchange Vendors

4. Congressional & Federal Activity • Grassroots Activity • Cosponsor total at 131! • Keep up the grassroots pressure with Operation Shout! advocacy messages • Congress Back in Session • Senator Ben Nelson (D-NE) sent letter blasting MLR impact on agents and brokers to HHS Secretary Kathleen Sebelius • Increasing pressure on the Department of Health and Human Services (HHS) to achieve a regulatory solution to MLR • Future Goals include: Regulatory action by HHS on MLR issue and/or the passage of federal legislation to remove broker compensation from the MLR requirement • Working with Senate offices to introduce a Democrat-sponsored Senate companion bill • NAIC still eyeing the MLR issue

5. IOM Essential Benefits Report Released • Institute of Medicine Releases Much-Anticipated Essential Benefits Report last Friday, Oct. 7 • - Report concludes that the EHB (essential health benefit package) should be defined by what is currently typical in the small-employer market • - Recommends a yearly-public hearing process for evaluating the benefits package • - Report stresses the importance of making health insurance affordable • EHB standards apply only to individual and small groups that are fully insured. • - The Treasury/HHS announced in August that a minimum value standard (still to be defined) will be used for large group/self-funded compliance

6. Developments in the PPACA Legal Challenges • Obama Administration seeks a Supreme Court decision on constitutionality question • Justice Department chose not to ask the 11th circuit court of appeals to re-hear the pivotal case but will appeal directly to the Supreme Court • The suit is the largest challenge to the health reform law including 26 states and the National Federation of Independent Business • The Administration has until November to issue their Supreme Court appeal • With a direct appeal from the Administration it greatly increases the odds that the High Court will hear this case • The timing of a final ruling is still left largely up to the justices, who may be cautious about ruling on such a high-profile case in the midst of an election.

7. PPACA’S CLASS ACT Under Fire • CLASS Act Investigation • Bicameral Republican Repeal CLASS Working Group releases critical report charging many in the Administration from keeping doubts about the CLASS Act from Congress and the American Public in an effort to pass PPACA. • Critics use this report to fuel calls for CLASS repeal • Rumors Fly that the CLASS Act Office is Closing at HHS • Lead HHS CLASS Act Actuary Bob Yee sends emails to his colleagues saying he is leaving his position immediately because the CLASS Act office at HHS is closing. • What is the significance?

8. Mark Your Calendar… • NAHU’s 2012 Capitol Conference • January 23-25, 2012 • Hyatt Regency Capitol Hill, Washington, D.C. • NAHU is Moving! • Office will be closed Friday, October 28 in order to move • New Address: • 1212 New York Avenue, NW, Suite 1100 • Washington, D.C. 20005 • Phone: 202.552.5060 • Fax: 202.747.6820

9. THANK YOU!! Next Legislative Update: November 9 at 1:00PM EDT