An Anonymous Guamblog reader wrote about the Legislature’s mistake in addressing consumer rebates, a critical component of the federal healthcare reform act recently held to be constitutional by the US Supreme Court:
“The Guam Legislature did not try to spend the employees and retirees rebates. The same law that appropriated the government share of the rebate made sure the employees and retirees rebate was protected. what everyone is being treated to is “fairy” tales. there is also more to the story than is being told everywhere and it due time it will surface.
Section 29. Payment of Subscriber Rebates. A new §4302.4. is hereby added to Article 3 of Chapter 4 of Title 4, Guam Code Annotated, to read as follows:
“§4302.4. Payment of Subscriber Rebates. The Insurance & Banking Commissioner of Guam, in a manner compliant with the Patient Protection and Affordable Care Act, shall pay or cause to be paid, rebates to all eligible subscribers of the Government of Guam Group Health Insurance Program as required by §2718(b)(1)(A) of the Public Health Services Act, as amended by U.S. Public Law 111-148, the Patient Protection and Affordable Care Act (PPACA).”
Working on behalf of an unthankful public in a thankless job is a true challenge. However, once an individual assumes the role of a lawmaker the onus is upon that individual to make sure legislation introduced is thoroughly researched and executable. Flawed legislation is a waste of productivity and defending the same nothing less than a disgrace.
The language cited above referring to changes in Guam Code Annotated attempting to place the responsibility for rebate payouts on the office of the invisible and lethargic local insurance commissioner (who I am sure makes a considerable salary with generous benefits and perks) is flawed.
While SelectCare is permitted to delegate its rebate distribution functions to GovGuam as the employer in this case, the carrier remains liable for complying with all of its obligations under the federal statute. It is not and shall not be the liability of the government of Guam to ensure reporting requirements for insurers.
SelectCare can request GovGuam administer rebates on their behalf to plan participants; however, GovGuam is NOT required to do so. The occupants of Adelup and our senators might not want to burden GovGuam with this responsibility, but in order to ensure receipt of the government’s fair share of the rebate, it may be necessary for them to take on this function.
If the legislature intended to assume through the office of the insurance commissioner (who would seem to more an advocate for insurers than he is for consumers) such a responsibility, then our diligent lawmakers should have ensured the government entered into a contract with SelectCare regarding the administration of rebates.
Wherein the above citation is the language that requires the government to assist insurers in dealing with all provisions of health care reform, not just MLR provisions?
Will SelectCare pay GovGuam what it is owed in a lump sum and then GovGuam cuts separate checks to all of the individual employees who are entitled to rebates? If that is what the legislature intended to happen, where is the enabling language making that clear in the above? And what of a contract/written agreement to adminster the rebates between SelectCare and GovGuam/Commissioner’s office - where is that and when did the legislature debate the matter?
If lawmakers intended for the Insurance Commissioner to be responsible for rebates - which cannot supercede the liability of the insurer imposed by federal statute - then of course they would have accounted properly for the required data collection, correct? I mean, Ilagan is weened on the public dole; not like he intends to actually do any spade work. So where is the “adequate funding” provided by the legislature for staffing?
Of course, GovGuam is the closest to the government employee population, so if the Commissioner is expected to be responsible for rebate distribution, which agency exactly would be designated to provide data to the commissioner and his new staff?
How would he receive the data that includes such details as to employee changes in coverage that may have occured during the year: which employees were terminated - and who would have to track them down?
Then of course, he would in turn have to provide all this data, an employee roster and premiums paid by employees and government to SelectCare before they could provide a check to GovGuam.
Somehow, the effort exerted by the legislature on this part seems to be wanting, and reflected in the flawed, insubstantial language of the newly amended GCA.