States with their own health insurance exchanges may be better off listen10/31/13 Janelle Irwin
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Healthcare exchanges in states that established their own marketplaces seem to be holding up better than those states that chose to use the federally facilitated website that has been marred by problems since it opened one month ago. Nearly 200,000 New York residents have completed applications on the state’s exchange website.
Ron Pollack is the executive director of the group Families USA. During a conference call Thursday, he claimed states that have not established their own marketplaces are likely at a disadvantage.
“Because of the different way that resources are allocated and the amount available, I would say that there is a significant difference between the states that are running their own exchanges which have more resources and therefore, on a per capita basis, a larger number of navigators and others doing this work than you have in the federally facilitated exchanges.”
Florida, along with many other states, chose to use the federal exchange. Jodi Ray is the project director for Florida Covering Kids and Families and is facilitating $4 million in federal funds to hire and train healthcare navigators to help people enroll in plans through the marketplace. She claims it’s going well and that people are constantly calling with questions, making appointments or just walking into offices around the state. But as of yet, Ray says there is no data to track how many people have completed applications. That’s something she says will change as the state starts tracking data on a monthly basis.
“So, we’re going to know who we’re reaching, how they’re applying, we’re even asking what application did they use, did they make a decision on their plans, what events were attended, what was the audience, how many people were reached, did enrollment occur as a result of these events? We’ve sort of been in the groove of collecting data like this for quite some time.”
North Carolina is also using Healthcare.gov instead of a state-specific website and they also don’t have any data available showing how many people have enrolled in health plans or completed an application. When asked how states can track their success or lack there of without data, Families USA’s Pollack said even if the numbers were available, it might not paint a very specific picture.
“No body ever expected that the numbers would be straight line numbers. In other words, that the number that would get enrolled in October would be the same as the number of people that get enrolled in December or February. Obviously, there’s been a significant information gap among people who can gain help through the Affordable Care Act. A substantial percentage of people who are eligible for subsidies who can get significant help, frankly have been just unaware of it.”
In New York, nearly 40,000 people have been enrolled in health plans – many of them Medicaid. They are one of 15 states to create websites independent of Healthcare.gov. Elisabeth Benjamin is the Vice President of health initiatives at the Community Service Society of New York. She says her state should be lauded for its roll out of the healthcare exchanges and talked about one of her success stories.
“Her life is not easy. She’s on minimum wage. She’s barely making 200% of the federal poverty level. I was able to sign her up for a silver product. She was eligible for cost sharing reductions which immediately bumped her up to a gold level benefit package and she will now be getting health insurance coverage for $77 a month. If she had tried to buy coverage on the open market in 2013, she would have been asked to pay $1,000 a month.”
Connecticut is also on the shortlist of states with their own marketplaces. Damien Fontenella with the state’s office of the Healthcare Advocate said exact figures about enrollment in Connecticut will be released tomorrow. But based on surveys conducted through October 15th, data suggests that more than 3,000 people may have completed applications. Fontenella said about 700 people completed the questionnaire.
“Eighty-two percent of them were extremely or very satisfied and 75% of those found that the website was very or extremely easy to understand which is critical for people going through this process. They really have to be able to understand what they’re doing.”
And as for the continuing glitches in the federal website, U.S. Secretary of Health and Human Services Sebelius said during testimony before Congress yesterday, that she’s confident the problems can be worked out quickly, but the assurances are doing little to quiet Republicans who detest the healthcare law. Families USA’s Pollack says the extended open enrollment period for the exchange was intentional.
“Because at the beginning of any program, there typically should be expected to be problems that are going to arise. So, this is a six-month enrollment period. The 182 days are more than three times longer than the 54 day enrollment periods that will succeed in the next years.”
In Connecticut, Fontenella told reporters there were some initial hiccups, but they’ve all been worked out. And as for criticism he’s heard, it has nothing to do with his state’s website.
“We haven’t gone down once. We’ve got extremely vigorous outreach efforts which are being very responsive and most of the concerns that we’ve heard expressed by both the assistor, navigator and broker communities and consumers as well, haven’t really involved anything with the enrollment process in Connecticut.”
The insurance marketplaces are only intended for certain people. Most people who already have insurance through an employer will keep their same coverage.