Rafael del Castillo arrived this morning in Washington D.C. The purpose of his trip is to get the definitive answer on whether or not Hawaii has to dump its previous healthcare laws in order to meet a July 1, 2011 deadline imposed under the Affordable Care Act.
To understand this issue, I'm going to quote huge blocks from emails from del Castillo. As a healthcare rights attorney, I don't want to even try to re-write it.
Back on March 4, del Castillo reported
Having been lead counsel for all but two or three of the consumers who have requested external review under our present law during the past ten years, I consider myself one of the most knowledgeable persons in the State on this topic. I interrupted work on a letter to Steve Larsen, Director of the Center for Consumer Information and Insurance Oversight at DHHS, which has the assignment under the health care reform act (Patient Protection and Affordable Care Act) to review each state’s external review law and decide whether it meets all of the 16 minimum consumer protections in the interim federal regulations. After July 1, 2011, health insurance issuers will be required by the CCIIO to comply with the federal external review law in any state in which the CCIIO determines the law does not meet those minimum protections, effectively preempting the state law until it is brought into compliance. This is apparently not a well-understood concept in Hawaii. (CCIIO staff explained to me that this passive preemption is due to the fact that the PPACA is part of HIPAA (Health Insurance Portability and Accountability Act).) In any event, on February 17, Prof. Richard Miller and I had a lengthy conversation with the CCIIO staff about our situation, and we were invited to submit a letter to Mr. Larsen explaining why we believe that Hawaii law meets all of the 16 consumer protections (with one minor exception that requires a technical correction). The one element that will be in question is whether the federal minimum requiring that consumer complaints be sent to an independent review organization (IRO) is met by Hawaii’s hearing process before a local panel of three persons, including a physician, plan administrator from a competing plan, and a DCCA lawyer. We believe that is superior to an IRO and has proven to be so, but a minor amendment to our existing law could offer consumers a choice of going to an IRO or a hearing.The problem is that by today, SB 1274 has been passed by the legislature and sits on the Governor's desk, without yet hearing back from the CCIIO. They have proved resistant to being rushed.
Governor Abercrombie has agreed to wait and see if del Castillo can get the necessary sign off on our current review system before deciding if he will sign SB 1274 into law.
Del Castillo has gone to Washington without having appointments to see the people he needs to see. On Sunday when he announced his trip, he asked supporters to email President Obama from his website to help get these appointments made and decisions reached.
I am not expecting open arms – they have their hands full with the pushback on the Affordable Care Act. Nonetheless, we are from the President’s home State. It will be a sad day if his push to expand Hawaii’s genius in health coverage to the nation results in substantial loss of rights in Hawaii.
You can urge the President to help us get an answer by contacting the White House using the form on this webpage: http://www.whitehouse.gov/contact
Sample message:
Dear Mr. President:
Greetings from your home state of Hawaii. I am writing to urge you to avoid an ironic turn of events which is potentially very embarrassing for the Affordable Care Act. Hawaii is poised to repeal its best-in-the-nation consumer protections because your CCIIO staffers refuse to say whether Hawaii law complies with the ACA regulations. Wouldn’t it be ironic if the ACA is reported to be responsible for the repeal of the law in the State that was a model for universal health care? Rafael “Del” del Castillo and many others have tried for months to get an answer from the CCIIO staff, but they refuse. Hawaii’s health plans have spent tens of thousands trying to persuade lawmakers that they should repeal our law, so Del decided to fly to Washington DC this week to meet face-to-face with the CCIIO decisionmakers.
He needs your help to get an appointment. Governor Abercrombie’s office has asked Del to bring back all of the information he can obtain to prevent the unnecessary loss of our consumer protection law. It is a no-win proposition for Governor Abercrombie if he acts to destroy our consumer protections without the information he needs. What a shame it would be to stick Governor Abercrombie with responsibility for destroying our consumer protections just because the CCIIO policymakers refuse to meet with Del for a few minutes.
Your office can reach Del at 808-782-1262. Please help him get an appointment.
Thank you for your kokua!
You can use the same page (and message) to ask the First Lady (except it is the President’s home state) if she will help (separate message, of course).
I will also appreciate anything you can do to encourage DHHS and DOL regulators to meet with me. You can email or call officials, but should do so Monday and Tuesday. I will let you know the shape of things Tuesday and what additional help I may need.
Hon. Kathleen Sebelius, Secretary, DHHS: Kathleen.Sebelius@hhs.gov Toll Free: 1-877-696-6775
Another person you can email in DHHS asking for help for me is Sadena Thevarajah because she is known for advocating for greater protections: sadena.thevarajah@hhs.gov
You can also contact the public affairs office for DHHS in this subject (a fax would be good):
Centers for Medicare & Medicaid Services (formerly the Health Care Financing Administration)
Phone: (202) 690-6145
Fax: (202) 690-7159
Sample message:
Dear ________________,
Greetings from our President’s home state of Hawaii. I have written the President, but I am also writing (calling) you to urge you to help Rafael “Del” del Castillo, who has flown from Hawaii to Washington DC this week solely to get a face-to-face meeting with the administrators in the CCIIO.
The Governor’s office has asked Del to bring back all of the information he can obtain to prevent wrong action on consumer protections. Del and others in Hawaii have tried for months without success to get an answer from the CCIIO, and we are distressed at their refusal to answer the question. Of course they are busy and we are only a small state, but we are the President’s home state, we were the model for the ACA, and wouldn’t it be ironic (and helpful to ACA opponents) if the ACA was responsible for destroying Hawaii’s best-in-the-nation consumer protections? Don’t you agree we are entitled to a meeting out of simple fairness?
Del can be reached at (808) 782-1262. Please call him and set up an appointment with the decisionmakers at CCIIO.
Hon. Hilda L. Solis, Secretary, DOL: solis@dol.gov Not toll free: (202) 693-6000
Another person you can contact is the Senior Advisor for Communications and Public Affairs Carl Fillichio, at (202) 693-4676 or
Public affairs Senior Managing Director Jaime Zapata, (202) 693-4676
The guy I really want to see is Deputy Assistant Secretary Michael L. Davis (202) 693-8300, Employee Benefits Security Administration (EBSA)
Public affairs offices are the way into the Federal agencies and they can be telephoned or faxed :
Office of Public Affairs
U.S. Department of Labor
200 Constitution Ave. NW, Room S-1032
Washington, D.C. 20210
(202) 693-4676
I will send a fax # when I get one Monday
Sample message:
Dear ________________,
Greetings from our President’s home state of Hawaii. I have written the President, but I am also writing (calling) you to urge you to help Rafael “Del” del Castillo, who has flown from Hawaii to Washington DC this week solely to get a face-to-face meeting with the administrators in the DOL EBSA.
The Governor’s office has asked Del to bring back all of the information he can obtain to prevent wrong action on consumer protections. Del and others in Hawaii have tried for weeks without success to get an answer from the ESBA, and we are distressed at their refusal to answer the question, or to even meet with Del. Of course they are busy and we are only a small state, but we are the President’s home state, we were the model for the ACA, and wouldn’t it be ironic (and helpful to ACA opponents) if the ACA was responsible for destroying Hawaii’s best-in-the-nation consumer protections? Don’t you agree we are entitled to a meeting out of simple fairness?
Del can be reached at (808) 782-1262. Please call him and set up an appointment with ESBA policymakers.
Aloha,
Rafael
Just after 5am local time, Rafael sent in his first email update.
I am here (Washington DC). Think POSITIVE thoughts! I intend to see the regulators at the CCIIO and DOL ESBA about preserving Hawaii’s existing external review law. Please let the Governor know that you appreciate his holding SB1274 until I can put our case to the Federal regulators.
If you think going to DC says “commitment” hold on to your seats. I signed up for twitter for this trip so you could follow me. I am a beginner, so have patience with me. Look for me at @Del4Hawaii
I arrived at O’Hare at 5:05 a.m. local time and left there at 6:25 bound for Reagan National Airport, where I arrived at 9:30 am local time. I immediately called Sadena Thevarajah of DHHS External Affairs, but had to leave a message on her answering machine – meetings, no doubt.
My shuttle took me over the bridge through the Capitol Mall. You can see the Washington Monument for miles around so you would have to work at it to lose your bearings in DC. With the Monument to my left, I looked up the Mall to the right, and saw the Capitol Building less than a mile away. The route to the Henley Park on Massachusetts Ave. took me across Pennsylvania at the 1400 block, but I did not see the White House. A few blocks from the Mall, less than 15 minutes from Reagan, I was dropped off at the Henley Park, my headquarters while I am staying here. I am glad I have a GPS in my phone to help me make get around quickly.
No time to spare. Follow me on Twitter (I hope) and listen to “The Conversation” with Beth Ann Koslovich on Hawaii public radio.
I just received an email from Anthony Rodgers, M.D., head of Strategic Planning for CMS. He understands the reason I am here and asked me to call. Good beginning!
Please support Rafael's efforts. I admit that I am biased and he has helped my daughter. But he also helped every other family I know of that has gone to him.
You can follow him on Twitter here.
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