Health Benefit Exchange

Barbara and Senator Northam (D – Norfolk) have filed joint legislation to create Virginia’s Health Benefit Exchange (HBE), required under the Federal Patient Protection and Affordable Care Act (ACA).  The proposal, SB 615, would implement the recommendations of the Virginia Health Reform Initiative (VHRI) Advisory Council. The market-based exchange is an incredibly valuable tool to lower health care costs and increase access to care for nearly one million uninsured Virginians. The legislation is modeled after recommendations from the Health Reform Initiative Advisory Council and creates a high level of transparency and provides consumers with a “navigator” to help identify the best insurance fit.

A key component of the ACA, the HBE will enhance competition in the health insurance marketplace and make insurance more affordable for individuals and small businesses.  Highlights of SB 615 include:


-        An independent Virginia Health Benefit Authority (VHBA) to run the HBE


-        A 15 member VHBA Board with 12 citizen members, four each appointed by the Governor, Senate, and House of Delegates


-        A requirement that qualifying health plans (QHPs) include all benefits now mandated in Virginia


-        A continued role for the VHRI in determining the essential health benefits to be required in QHPs


A subcommittee of the Senate Committee on Commerce and Labor will hold a hearing on SB 615 Wednesday at 8:00am in Richmond.






Richmond, VA — February 15, 2012 —Today, Senator Barbara A. Favola (D - Arlington) and Senator Ralph S. Northam’s (D - Norfolk) legislation promoting the needs of Virginia health care consumers took a back seat to insurance companies as the General Assembly postponed action on Health Benefits Exchange legislation.




A bill favored by the health insurance industry remains in play and will be used as a starting point when the General Assembly meets again in 2013, while Senators Favola and Northam’s legislation was tabled. During the debate, the so-called “Anthem Bill” was championed by Health Insurance Subcommittee Chairman and insurance industry insider Senator Jeff McWaters (R – Virginia Beach), a former CEO of Amerigroup Corporation.




Senators Favola and Northam’s legislation was preferred by consumer advocates and closely followed recommendations of the Governor’s Health Reform Initiative advisory panel. In their legislation, the HBE was located in a newly created quasi-governmental agency with strong requirements for transparency and accountability.




“It is a mystery to me why Democrats and Republicans both acknowledge the urgency of moving forward on reforming our health care system, but we’re seeing partisan obstruction in the Senate committee. It is important to move forward before the federal government dictates the specifics of a Health Benefit Exchange. It’s important to do it right, and do it the Virginia way,” said Senator Favola.




 “I am concerned that the Republican legislation neglects crucial recommendations made by the bipartisan Virginia Health Reform Initiative Advisory Council. This Council created a balanced and fair approach to a complex topic with input from legislators, experts and health industry leaders handpicked by Governor Bob McDonnell, and now we’re seeing over a year of hard work dismissed in one afternoon,” added Senator Favola.




Senator Northam said, “As a physician, I know how difficult it is going to be to get this exchange set up in time, even if we act now. By kicking the can down the road, Governor McDonnell and Senate Republicans have made yet another irresponsible decision.”




In January, AARP and Virginia Consumer Voices released survey results that show a majority of Virginians want consumers to be represented in creating the new health exchange and that they oppose insurance company influence.




“Most Virginians agree the majority of members sitting on the governing board of the state health insurance exchange should be consumers or consumer representatives, and most oppose insurance company representatives serving on the governing board,” said AARP Virginia State Director Bill Kallio.