On the State Exchanges: Developments Weeks of 8/19 and 8/26
September 24, 2013
Less than two weeks remain until state health insurance exchanges under the ACA being accepting enrollments. As states prepare to either implement their own exchanges or let the federal government set up shop on their behalf, some states are expressing concerns that they will not be ready in time, while others are confident. Advertising and informational campaigns are amping up in anticipation of the launch, with all states working to educate their residents about their options under the new system.
The State Exchange Table continues to provide the latest information on carrier participation and plan rates as they occur.
State Run Exchanges-
California: Politico identified California as one of the three “swing states” – states with the largest uninsured populations that play an outsized role in the success or failure of Obamacare. Together, Texas, Florida, and California make up one third of the nation’s 46 million uninsured. State officials in California have already provided $43 million for consumer outreach and have hosted numerous town halls and other informational events.
California also faces a potential delay in launching its online enrollment for Covered California, the state’s health insurance exchange. A spokesman for the exchange cited continued testing of the technology for enrollment as an obstacle to timely implementation. Despite the projected delays, a Covered California rep confirmed that consumers will be able to enroll over the phone or in person on time, beginning October 1st.
Colorado: Colorado recently released finalized rates for plans on its public health insurance exchange, joining 13 states and the District of Columbia in doing so. The state operates a clearinghouse exchange, meaning they approved all 242 plans submitted under its state-run program, Connect for Health Colorado.
Colorado state insurance commissioner Marguerite Salazar expressed concern over the approaching “bumps in the road” to implementation of the state’s health insurance exchange. Yet unknown are the robustness of the online system and residents’ level of familiarity with buying their own insurance. As the October 1st deadline approaches, an estimated 200,000 uninsured Coloradans wait to enroll. Despite her concerns, Salazar is confident that Colorado will have a functioning exchange by the deadline.
Connecticut: Connecticut announced plans to open “storefronts for Obamacare,” boutique-style spaces with the aim of educating the public about the state’s health insurance exchange, Access Health. The first wave of storefronts will be in low-income areas, with the goal being to inform “hard to reach” populations that spend less time online or watching the news. The eventual goal is to have locations throughout the state.
The intent behind the storefronts is to address the issue of “How do we bring health care into the community?” Styled after Apple retail stores, the locations will have brokers on hand to walk consumers through their options and advisors similar to Apple Geniuses to help individuals with more complicated and specific issues.
Florida: Florida, identified by Politico as a “swing state” in determining the success or failure of Obamacare, has an estimated 3.9 million uninsured individuals under 65. Enroll America, a non-profit group dedicated to encouraging Floridians to enroll, currently has 27 staffers on the ground, with plans to hold information sessions, knock on doors in neighborhoods with high concentrations of the uninsured, and set up tables at community gatherings.
Idaho: Idaho recently debuted a new health insurance exchange website, www.yourhealthidaho.org. The state only voted to approve a state-run exchange in March, so the site will initially serve simply as a gateway to the federal website, but Idaho officials hope to have a state-run online enrollment site up and running by the end of the year.
Illinois: To be prepared for the impending open enrollment period, Illinois is hiring a team of 800 temporary workers to serve as “in-person counselors.” These counselors will help consumers apply for coverage and will answer questions and explain differences between the insurance policies offered on the new online marketplace. Training sessions began in July and will continue through the October 1st enrollment start.
Kentucky: Health workers in Kentucky are doing outreach amidst the corn dog stands and cotton candy vendors at state fairs to educate Kentuckians about the state’s health insurance exchange, called Kynect. Workers attempted to simplify the complexities of the new system, distilling the program down to three simple phrases: “We are Kynect – part of the new health care law,” “Do you know anyone who doesn’t have health insurance?” and “You may qualify for Medicaid or a tax credit based on your income.”
Michigan: Michigan’s newest health insurance company, Consumers Mutual, has launched an educational campaign around enrolling in health insurance that features “billboards, radio spots, TV spots, and print and digital advertising.” The ads center around “Healthee” – a red and black animated character that guides viewers through the enrollment process.
Despite resistance from Michigan Republicans in the legislature, Governor Rick Snyder is advocating for increased outreach to inform individuals about health insurance exchanges. Coalitions such as Michigan Consumers for Health Care support the outreach effort aided by the $2.5 million federal grant for “navigators.”
Nebraska: Nebraska released its health insurance exchange rates, which initially appeared to be higher than other state exchanges. However, rates do not take into account the yet-unreported federal subsidies to be made available and therefore may be subject to change. The rates also do not apply to individuals covered by employer health plans or Medicare.
The state convened for the first meeting of the Nebraska Exchange Stakeholder Commission, a panel of Nebraskans in charge of oversight and advice for the new health insurance exchange. The 11 member panel includes “consumer representatives, small-business owners, a farmer and taxpayer advocate, a health insurance agent, a hospital administrator, a doctor and an insurance company representative.”
New Mexico: State officials announced that implementation has begun on outreach efforts to educate the state’s residents about their options under the new, state-run exchange in advance of the open enrollment date. J.R. Damron, M.D., Chair of the New Mexico Health Insurance Exchange (NMHIX) Board, stated “We are launching this comprehensive system to make sure that all New Mexicans understand the new health coverage options and give them the information as well as local help to get signed up.”
New York: Health insurance company Aetna pulled out of the New York state health insurance exchange, called New York State of Mind. This is the latest in a series of opt-outs by Aetna. Other states it has opted not to participate in include Maryland, Ohio, Georgia, and Connecticut. The health insurance company sites risk associated with the initial launch as the reason for opting out. “We have taken a prudent risk-based approach to both our overall exposure and exposure within a given marketplace,” Chief Executive Officer Mark Bertolini said.
Rhode Island: Rhode Island released its final rates for individuals and small businesses under the state-run exchange, known as HealthSource RI. Health insurance providers for the state are Blue Cross & Blue Shield of Rhode Island, United HealthCare, and Neighborhood Health Plan of Rhode Island.
Tennessee: Tennessee is calling on churches as well as secular channels to inform individuals about the federally-run health insurance exchange. Experts estimate that 30,000 uninsured individuals will enroll in the exchanges come October 1st through one of the state’s four health insurance providers – BlueCross BlueShield of Tennessee, Cigna Healthcare, Coventry Health & Life, and Community Health Alliance.
Washington: Washington state launched an ad blitz to publicize its online health insurance marketplace, called Washington Healthplanfinder. The goal of the advertising is to sign up 130,000 uninsured people by the end of 2013 and 280,000 in 2014 via the online enrollment tool. The state has received $26.3 million from the federal government allocated for marketing and outreach efforts.
Federally Facilitated Exchanges-
Alaska: Alaska regulators have approved two companies to provide health insurance under the state’s federally-run health insurance exchange: Premera Blue Cross Blue Shield of Alaska, the state’s largest insurance provider, and Moda Health. Senator Hollis French has high hopes for the exchange – the details of which will remain relatively in the dark until the January 1st start. State law prohibits releasing the rates until that time, but French is hopeful they will reflect the savings experienced by other states. “We hope that Alaskans experience the same reduction in cost that other states have seen as the exchanges go into effect and roll out their estimates,” he said.
Arizona: The Department of Health and Human Services (HHS) and AARP will be taking the lead on helping Arizona residents sign up for the federally-run health care exchange come October 1st. A combination of bilingual resources and “user-friendly” websites will be used to walk Arizonans through selecting and enrolling in a plan.
Georgia: College administrators at the University of Georgia received a $1.66 million federal grant to train and deploy “navigators” to walk Georgians through the process of enrolling in health insurance under the new federally-run exchange starting October 1st. According to federal requirements, the navigator will dispense “fair, impartial and accurate information that assists consumers with submitting the eligibility application, clarifying distinctions among (qualified health plans) and helping qualified individuals make informed decisions during the health plan selection process.”
Missouri: A St. Louis-based non-profit, Missouri Foundation for Health, will vote “to supply $1.1 million worth of posters, wallet cards and other promotional materials about the exchange” to educate Missourians about the federally-run exchange. Missouri residents largely remain in the dark as the open enrollment period nears. Missouri is one of the 19 states that has opted to let the federal government run its exchange and has done little thus far to publicize the program within the state.
Montana: Montana released rates for its federally-run insurance exchange. Rates are available from three carriers offering plans to state residents – Blue Cross Blue Shield of Montana, PacificSource, and the Montana Health CO-OP. Montana Commissioner of Securities and Insurance, Monica Lindeen, said she was “pleasantly surprised” by the rates despite initial concerns about the program. She also appreciated the fact that Montanans with preexisting conditions will not denied coverage or priced out of the market.
Texas: Politico identified Texas as a “swing state” that could make or break Obamacare depending on how many of its residents enroll in insurance exchanges starting October 1st. With the second highest uninsured population after California (Texas has an estimated 5.8 million uninsured people under 65), Texas is essential in reaching enrollment goals set by the federal government.
In an effort to educate Texans about how to use the federally-run health insurance exchanges, the local branch of the United Way (Tarrant County) applied for grant money to help train and deploy navigators. The United Way received $5.9 million and aims to reach 62,000 Texans in face-to-face meetings and 500,000 through phone calls and community meetings, according to the organization’s president, Tim McKinney.
Utah: According to state insurance officials, Utahns will have at least 99 plan options through the new online health insurance marketplace. Participating insurers are Altius Health Plans, Arches Mutual Insurance Co., BridgeSpan Health Co., Humana Medical Plan of Utah, Molina and SelectHealth. Utah is unique in that it is the only state that will be splitting coverage between the state and federal government, with the federal government running the marketplace for individuals and the state of Utah operating Avenue H, an exchange that caters to small businesses.