What's Next for Health Exchanges?

2012 National Conference

CSG Health Policy Task Force
What's Next for Health Exchanges?
December 1, 2012

As the political dust surrounding health care reform settles, states are getting down to the business of establishing health insurance exchanges. Participants learned more about key health insurance exchanges issues in the 2013 legislative sessions. This workshop examined exchange planning and implementation efforts—looking at issues for both state-based and federally facilitated approaches, including partnerships. The panel focused on topics such as governance, regulatory oversight and financing, as well as general exchange policy.

Session Summary:

Speakers Paula Flowers and Brett Graham advised state decision makers that opting for a state-operated health insurance exchange is the best way for states to retain control over their state insurance markets. However, each acknowledged that a number of states have deferred to the federal government to run their state insurance exchanges. States that have not yet made a decision – about ten or eleven – and that have not already done considerable planning may be too late for the December 15 deadline.

Ms. Chiquita Brooks-LaSure, director of coverage policy for the U.S. Office of Health Reform, said states can decide to operate a state-based exchange at any time. Ms. Flowers said states should look for the “on ramp” that will be available to states. Ms. Brooks-LaSure urged state decision makers to review draft regulations just released and make comments.

Ms. Flowers, a former Tennessee insurance commissioner, told session attendees that they should expect insurance companies and health care providers to be active in the 2013 legislative sessions. The deadline for states to declare that they will run exchanges in partnership with the federal government is February 15, 2013. Also a number of states will need to pass state legislation to be in compliance with insurance mandates of the Affordable Care Act. 

Capitol Ideas Today:  "States Still Have a Long Way to Go on Health Exchanges"

Speakers and Presentations:

  Chiquita Brooks-LaSure, DIrector of Coverage Policy, Office of Health Reform at the Department of Health and Human Services

  Paula Flowers, Health Consultant and former Tennessee Insurance Commissioner, Oak Ridge, Tenn. National Laboratory

  Download the Presentation: "Health Insurance Exchange Implementation: The Road Ahead" in PDF (without audio) or as a Video (with audio)

  Brett Graham, Partner, Leavitt Partners

  Download the Presentation: "Health Insurance Exchanges: Past, Present and Future" in PDF (without audio) or as a Video (with audio)

Speaker Biographies:

Chiquita Brooks-LaSure
Chiquita Brooks-LaSure is the director of coverage policy in the Office of Health Reform (OHR) at the Department of Health and Human Services (HHS). OHR provides leadership and coordination of the development of the Administration’s policy agenda across agencies for the Affordable Care Act of 2010. Within OHR, Chiquita is responsible for policies regarding health insurance reforms, Exchanges and the expansion of Medicaid coverage.

Prior to joining HHS, she was Democratic staff for the US House of Representatives Ways & Means Committee. There, she played an integral role in the passage of the new health care reform law.  Prior to joining the Committee, Chiquita was a director at Avalere Health, a strategic advisory group that advises clients on health policy. From 1999 to 2003, she worked at the White House Office of Management and Budget. Chiquita received her AB from Princeton University and her MPP from Georgetown University.

Paula Flowers: 

Paula Flowers is currently employed as part of the management team at the Oak Ridge, Tenn. National Laboratory. Also as president of Enovation Group, she provides project development and management services to the government, energy and healthcare sectors.

Flowers served from 2003 to 2007 as commissioner of Commerce and Insurance for Gov. Phil Bredesen. She supervised 800 employees and administered revenues of more than $400 million. Her responsibilities included the regulation of the insurance industry, the securities industry and the array of boards that govern the state's licensed professionals. She also served as the state fire marshal.

A native of Monterey, Tenn., Flowers previously worked as an attorney and an environmental compliance engineer at Y-12. She holds a Bachelor's degree in Civil Engineering from Tennessee Tech, a Master's degree in Civil Engineering from McNeese State University, and a law degree from the University of Tennessee, where she graduated Summa Cum Laude.

Brett Graham
Brett Graham is a partner at Leavitt Partners and directs Leavitt Partners’ health insurance exchange practice, where he provides strategic advisement and resources to a variety of insurance exchange clients. 

Prior to joining Leavitt Partners, Graham led the operations and sale of a regional administrator of self-funded benefit plans to Meritain Health. Following the transaction, he led the post-merger integration and was a member of Meritain’s strategy team. Before his time at Meritain Health, he worked as a vice president at UnitedHealth Group within the Ingenix business unit. Graham joined the business development and strategic planning team where he was responsible for conducting analysis on acquisitions and strategic partnerships during a period of hyper-growth where Ingenix completed 26 acquisitions and grew from $280 million to $1 billion in revenue. Later he formed the market research team that developed competitive intelligence. Graham moved to operations and was the business leader for Ingenix’s pricing databases (i.e. MDR & PHCS) where he was responsible for working with large payers to aggregate and analyze claims data.

In a previous role, Graham served as a management consultant with the Boston Consulting Group where he worked with senior business leaders to develop growth strategies for Fortune 100 clients. His clients were in highly regulated industries with global operations.

Graham holds a Master’s degree in Business Administration from the Harvard Business School and a Master’s of Public Administration and a Bachelor’s in Accounting from the University of Utah. While a student at the University of Utah, he was elected student body president and served on the University Board of Trustees.


flowers.pdf507.43 KB
graham.pdf577.53 KB