The federal health reform law, a landmark piece of legislation passed by the Democratic-controlled Congress and President Barack Obama two years ago today (March 23), has delivered on its promise to change health care in the U.S.

Delaware’s insurance commissioner approved the affiliation between Blue Cross Blue Shield of Delaware (BCBSD) and Highmark, imposing 49 conditions designed to protect consumers and BCBSD.

Former Maryland Insurance Commissioner Ralph S. Tyler, who left the Maryland Insurance Administration in January 2010, now has left his position as chief counsel of the U.S Food and Drug Administration.

Beth Sammis, the acting Maryland insurance commissioner for nearly 18 months, ending in June, has taken a job at CareFirst BlueCross BlueShield, one of the health insurance companies she regulated.

William L. Jews, a former CEO of CareFirst, can now claim all $18 million of his severance, five years after he left his position leading Maryland’s largest health insurer and three years after the payment was challenged by state officials.

Increased “cost pressures” facing health insurers could mean that an effort to free insurance agent and broker commissions from the grip of the federal health reform law might not lead to restored payments.

The Delaware Department of Insurance has scheduled three public hearings in May to address the proposed affiliation of Blue Cross Blue Shield of Delaware with Highmark Inc.

The U.S. Justice Department has expanded an investigation of Blue Cross/Blue Shield licensees’ alleged anti-competitive agreements with hospitals beyond Michigan, where it filed an antitrust lawsuit against the insurer.

Delaware state attorneys appear to have negotiated a deal permitting a public review of financial projections for Blue Cross Blue Shield of Delaware in connection with its planned affiliation with Pennsylvania insurer Highmark Inc.

The Washington, D.C.. council unanimously passed a bill imposing new limits on health insurance premium hikes for CareFirst BlueCross BlueShield, D.C.’s largest health insurer, as well as other health plans.