Poughkeepsie Journal from Poughkeepsie, New York • Page A2

2A TUESDAY, November 17, 2015 poughkeepsiejournal.com Lawsuit Continued from Page 1A Failed Continued from Page 1A "Many proponents of the co-op program are now stressing the inherent challenges new insurers face to achieve viability," Harrington wrote Thursday in a Forbes op-ed. SEQRA is an environmental impact assessment that takes into account the environmental impacts with social and economic factors when deciding on something. Lithco said this assessment includes examining the impact on the community and environment. "The district's contention is that the lead agency has not taken that hard look because the land-use approvals are void," he said. "The impact on fire districts and the service that it provides, that hard look has not been taken." Judge Christine Sproat, of state Supreme Court in Dutchess County, last month dismissed the lawsuit against the local government entities and the Fair-view Commons project that was filed last year.

The case was dismissed because the district lacked "standing," which attorneys said suggested that the claims the district brought were not related to the SEQRA process. "You can't be heard because you're not raising environmental and zoning issues, you're raising an economic issue," said Richard Cantor, an attorney at Tea-han Constantino in Poughkeepsie who represents Page Park and Linda Dalia. Litcho said the district has appealed Sproat's decision, and also is waiting to hear on a "preliminary injunction" to stop construction at the Fairview Commons site until the appeal is heard. "I believe there is a strong argument that the district does have standing," he said. "It's my belief that the district will prevail on appeal and those issues will be considered." Amanda Fries: afriespoughkeepsiejournal.com 845-437-4824; Twitter: mandyjries Others stepping in Under Friday's agreements, Fidelis, Excellus and MVP have agreed to automatically enroll Health Republic members on Dec.

1 and credit any deductible and out-of-pocket expenses already paid for this year. This week, Health Republic customers who have not yet selected a new health plan for Dec. 1 will receive an auto-enrollment notice from state Health Department telling them based on their county of residence who their insurer will be. Individuals who reside in Ulster County will receive an offer to enroll from Schenectady-based MVP, while everyone else will get an offer from Fidelis Care, which is also based in the Albany area and last year was the largest private insurer under the state's exchange. "Like other health plans, Fidelis Care is working closely with the state Department of Health to ensure that Health Republic members have the information and resources they need to choose a new plan for their coverage, and to help make their transition as seamless as possible," Dave Thomas, the COO and at Fidelis Care.

Warning signs? The problems with Health Republic were years in the making. After its first year of operation, Health Republic in 2014 sought a 15 percent increase in rates, among the highest sought by any insurer. The state, though, pared back the increase to 13 percent. For 2016, Health Republic sought a 14 percent hike again one of the largest on the exchange. The state Department of Financial Services, which sets the rates, said it has done its due diligence in trying to limit the damage from Health Republic's demise.

"Going forward, we will continue to do everything we can to protect these consumers," the agency's superintendent, Anthony J. Albanese, said in a statement. Meanwhile, the enrollment period opened Nov. 1 for the more than 2 million customers on the exchange to pick their insurance for 2016. The enrollment period runs until Dec.

15 for coverage starting Jan. 1. Hospitals, insurers worried Hospitals and doctors fear they could get stuck with Health Republic's tab. Hospitals alone are estimated to have at least $160 million in liabilities from Health Republic. The state Healthcare Association, which represents hospitals, is urging the state to set up a guarantee fund to reimburse providers who could be on the hook for Health Republic's insolvency and perhaps other insurers on the exchange that might face a similar fate in the future.

The group said it "continues to raise very serious concerns about the consequences of such a tremendous financial loss when hospitals are already financially fragile." But insurers are taking issue with the hospitals' push, saying the proposal may pass the added costs onto insurance companies through higher fees. "To address the immediate problem of unpaid Health Republic claims, we would propose use of state dollars like the hundreds of millions in funds the state uses to bail out failing hospitals in New York," the state Health Plan Association, which represents insurers, said in a statement. The insurers have been fighting with the state over cuts to their proposed rate increases in recent years, and now they are suggesting that the state's stance isn't financially viable. "There is plenty of time in the weeks and months ahead to talk about solutions to avoid another Health Republic-like event," the Health Plan Association continued. "Part of those discussions must address reforming New York's current prior approval process and the need for truly transparent rate setting that ensures plan premiums are adequate and actuarially sound." Joseph Spector: jspectorgannett.com.

www.twitter Smoke Continued from Page 1A are urging the state to create a fund to bail them out if they are stuck with Health Republic's unpaid bills. "It is extremely important to determine what led to Health Republic's failure, and it it our intention to pursue legislation to avoid such a catastrophe in the future," state Sens. Kemp Hannon and James Seward, two Republicans, wrote to state regulators Thursday. Popular plan The state announced on Nov. 8 it would automatically enroll the 200,000 Health Republic patients into new plans, if they don't themselves pick a new provider, to ensure continuity of care.

The enrollment will be based on where customers live. "While we encourage Heath Republic customers to act as soon as possible to pick new insurance plans, this auto-enrollment option is critical to helping ensure a smooth transition to new coverage," said Donna Fresca-tore, executive director of New York State of Health, the state's health exchange, in a statement. Health Republic, which covered about 20 percent of exchange's enrollees, is the largest insurer in the exchange in many counties, including in Erie, Dutchess, Ulster, Putnam and Westchester counties. It is the second-largest insurer in Monroe County. Between small-business employees and individuals buying Health Republic on the open marketplace, Westchester had 20,400 customers, the state Healthcare Association of New York said.

Erie County had nearly Rockland had and Monroe had 3,000. There were few customers in the Southern Tier. The Manhattan-based cooperative, the largest in the nation, offered extraordinary low rates, leading them to become a popular choice particularly among young people in the state's exchange, which opened in 2014. But the rates proved to be too low and the company's revenues couldn't keep up with the demand as federal aid dwindled. Last year, it lost $78 million, financial disclosure forms showed, and that's even after the federal government gave the company more than $264 million in loans to stay solvent.

Loss of aid Federal aid started to dry up in Washington amid the ongoing battle over the Affordable Care Act, leaving Health Republic and other nonprofit insurers created under the act in peril. At least 10 of the co-ops in the nation are shutting down or already have. "This is a new program. The whole thing is new, and it was very hard to figure out where the risk was going to land," Sherry Glied, dean of New York University's Wagner Graduate School of Public Service, said. The final straw for Health Republic was the pending announcement from the federal Centers for Medicare and Medicaid Services that would cut a type of aid called "risk corridor" assistance.

The federal government decided ultimately on Oct. 1 just days after the state said it would close Health Republic to pay just 12.6 percent of what was expected to the cooperatives. It was a big hit to Health Republic, the company said. "Considering the insurmountable financial gap created largely by the risk corridor program only paying out 12.6 percent of the $149 million Health Republic was owed for 2014, we believe winding down on Nov. 30 is a prudent decision," the company said in a statement last month.

The cooperatives were to be a counterweight to the major private insurers. But the co-ops have struggled with the wherewithal to sustain losses of federal aid and deal with some regulations. For example, companies like Health Republic had enrolled healthier patients which lowered their costs. But under so-called Obamacare, the companies must pay to compensate companies with sicker-than-average enrollees, leading to higher expenses, said Mark Harrington, chairman of the health-care management department at the University of Pennsylvania's Wharton School. The precise time will depend on weather conditions such as humidity and wind.

The burn is part of a larger plan to reduce excess debris from the forest floor that can fuel larger wildfires. That plan was drafted after the 2008 Overlook Fire consumed 3,100 acres of Minnewaska State Park Preserve and private lands. It also threatened as many as 30 homes. Since then, about 440 acres along the ridge have been burned under controlled conditions, an area equaling about half the size of Central Park. Chapin said dry weather conditions in the spring as well as a wildfire that burned thousands of acres near Ellenville have kept ecologists from conducting controlled burns this year.

"This is probably just the second time in 10 years we weren't able to do any burns in the spring," he said. Fire management officials hope that in addition to reducing the chance of wildfires, their efforts will improve the health of the area's oak forest. Oaks produce acorns, a key food source for wildlife. Oak forests rely on a regular cycle of fire to beat back some of the competition for sunlight. Locally, that competition comes from red maple.

Better fire-suppression techniques and more aggressive education have prevented the natural occurrence of those fires, spurring an overabundance of red maple. John Ferro: 845-437-4816; jferro poughkeepsiejournal.com; Twitter: PoJoEnviro Poughkeepsie Journal PoughkeepsieJournal.com GETTING IT RIGHT The Poughkeepsie Journal corrects errors of fact. To report a correction or clarification, call 845-437-4834. Chart mislabeled The time frame depicted in a chart that appeared on page 1A of the Nov. 15 edition of the Journal was mislabeled.

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