WHEREAS:
The Affordable Care Act (ACA) establishes health insurance exchanges to facilitate subsidized purchase of health coverage for millions of previously uninsured individuals and families; and

WHEREAS:
The ACA requires states to create health insurance exchanges or to rely on the federal government to operate such an exchange in the state; and

WHEREAS:
The ACA provides that exchanges must be operated by a public entity, a non-profit corporation created by a state, or by the federal government; and

WHEREAS:
The many essential functions of an exchange include regulating insurance products sold in order to maintain a fair marketplace, certifying which insurance products meet the minimum benefit standards to be offered, determining eligibility for premium subsidies as well as the new Medicaid expansion population, and coordinating with the state Medicaid office to ensure seamless transition between the programs; and

WHEREAS:
Such functions require the utmost in transparency and accountability, are integrally based on public trust and are inherently-governmental; and

WHEREAS:
Recent rules issued by the U.S. Department of Health and Human Services (HHS) would allow states to contract out many of the essential exchange functions, including determination of eligibility for the new Medicaid benefit.

THEREFORE BE IT RESOLVED:
That AFSCME and its affiliates will work through the administration and Congress to modify the recent HHS rules to promote the public operation of state health insurance exchanges and to ensure that a federal exchange is publicly operated; and

BE IT FURTHER RESOLVED:
That AFSCME and its affiliates will work to ensure that public merit system personnel continue to do the critical work of Medicaid eligibility determination, as well as assuming the new work of eligibility determination for premium credits.

SUBMITTED BY:
Anthony J. Caso, Executive Director
AFSCME Council 93
Massachusetts

Joanne Cooke, President and Delegate
AFSCME Local 72, Council 93
Massachusetts