Four states — Hawaii, Nevada, New Mexico and Oregon — that received more than $700 million in grants to establish exchanges have resorted to using HealthCare.gov as their platform. Now, Republican lawmakers want answers on why they are still collecting user fees.
The agency requires most Qualified Health Plans to pay a 3.5 percent fee on plans sold through the federally-facilitated marketplace, but the flexibility granted to state exchanges to set up and collect the fees has become a concern for the congressmen.
Top members from the House Ways and Means Committee and House Energy and Commerce Committee expressed their unease over Oregon and Nevada retaining 100 percent of the fees.
“CMS has apparently allowed at least two of these states (Oregon and Nevada), to retain 100 percent of the fees they collected,” wrote Ways and Means Chairman Kevin Brady, Ways and Means Subcommittee on Oversight Chairman Peter Roskam, House Energy and Commerce Chairman Fred Upton and Energy and Commerce Oversight and Investigations Subcommittee Chairman Tim Murphy. “Essentially, this allows Oregon, Nevada, and any other state with this particular arrangement, to use the FFM for free while pocketing user fees charged to QHPs in their state for their own use.”
The congressmen said taxpayers should not be on the hook for the costs.
The lawmakers called on the agency to provide information on all agreements between the states and related to the FFMs and how much of the establishment grants.
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