Health Insurance Exchange Update: Friday, October 12

We are less than a month from the November election, and many states are still scrambling with last minute details about their health insurance exchange.

Minnesota has received around $70 million in federal funding to create their health insurance exchange, but the state is saying that it will also cost them $40 million to run the exchange. Minnesota budget officials estimate it could cost the state as much as $40 million to run its health insurance exchange in 2015. The state-based online insurance marketplaces are a cornerstone of the federal health care overhaul. The initial $70 millions was used towards creating contracts, hiring staff, and designing the exchange.

 Connecticut Health Insurance Exchange CEO Kevin Counihan's latest message includes highlights from September, and plans for the future. Counihan discusses the condensed time frame they have to work with, and is also very gracious for the patience and assistance from everyone involved. With the contracting of Deloitte Consulting, we have begun the complicated work of IT architectural design and interface connection for our new integrated eligibility system. This is a 3 ½ year implementation being compressed into 12 months. He then discusses some of the problems that the state is facing, starting with passing the ACA. Finally, although they want a more consumer focused exchange, they won't be able to customize it as much as they had hoped for until 2015.

In New Jersey, Governor Christie has chosen a 'wait and see' plan when it comes to creating a program for his actual state, but he seems to be adamant on moving forward when it comes to his own plans.The dueling priorities of the legislative and executive branches are typical in the state capital these days — Democratic lawmakers come to Trenton to pursue their agenda while the Republican governor hits the road to pursue his. Assemblyman Herb Conaway is hoping the new legislation that includes some of Christie's suggestions will finally get passed, especially with November being less than a month away.

Want to learn more about the health insurance exchange? This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!  

Health Insurance Exchange Update: Monday, October 1

State Flag of Maryland

One year from today, health insurance exchanges will open for enrollment.  For those states who have committed to how the state will run their exchanges, they are now working on the logistics of running it a year from today.

While exchanges are set up to easily represent the choices available when selecting health insurance, Minnesota is worried about how to easily understand what choices are available.  So the state is bringing in "Warm Connectors."  When choosing a health plan through work, employees can go to their human resources representative, and the state is hoping that the Warm Connector will function much the same to answer any questions that go through the exchange.  However, now the state is figuring out who will have this job.  Should it be the insurance brokers who already have an in-depth knowledge base on this topic? If so, how will they be compensated?  Minnesota Public Radio has more on the topic.

Maryland recently came to some big decisions about their basic health plan that will be offered through the exchange.  Those offered in the private market will be modeled after the insurance the state employees receive.  The state also ruled that in vitro fertilization will not be covered on the basic plan, setting the benchmark for the items that will be covered.  The Baltimore Business Journal has more.

And finally, South Dakota Governor Dennis Daugaard has decided that the state will be unable to run an exchange.  They will use the one provided by the federal government.  They will ask the federal government to maintain the authority to regulate the insurance plans.  The government still hasn't released what benefits that exchange will include according to the Insurance Journal.

Want to learn more about the health insurance exchange? This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!  

Health Insurance Exchange Update: Friday, September 28th

In preparation for the Health Insurance Exchange launch next October in Colorado, three Denver based non-profits have spent the past few months collecting consumer based research data. The mission of the exchange is to give consumers the most affordable options, and lower premiums. It will also be a place to compare and contrast health plans, and review tax credits. Common suggestions from the public have included: live chat assistance from neutral and knowledgeable staff; a glossary to explain obscure insurance terms; concise, visual summaries of plans in layman’s terms; and involvement from consumer watchdog groups such as the Better Business Bureau. There will also be alternative options for people who are unfamiliar or do not wish to use the internet.

After receiving a $42.4 million federal grant, Minnesota continues to develop their new Health Insurance Exchange program. The state has received around 71 million to assist in building their program. "This grant allows us to continue the technical work needed to allow Minnesota to design and develop a state-based exchange," said Jim Schowalter, commissioner of Minnesota Management & Budget, in a statement.  The state must complete a blueprint of the plan by November 16th.

The supreme court has ruled the new federal healthcare law to be constitutional, but under Propsition E citizens of Missouri will be able to cast votes on insurance exchanges. Proposition E on the November ballot would prohibit Gov. JayNixon or any state agency from setting up a health insurance exchange without the approval of the legislature or the state’s voters. However, the federal law will only allow this block to be temporary, by 2014 an exchange is required each state.

Want to learn more about the health insurance exchange? This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!  

Health Insurance Exchange Update: Monday, August 13, 2012

Minnesota State Flag

With the Supreme Court passing the legislation to keep the Affordable Care Act for the most part in tact, many states are still questioning what they should do. However, others are taking steps to make their exchanges a reality while others are looking at the impact of Medicaid expansion on their state and budget.

Minnesota is one of the first states to award a contract to a technology company in order to create their exchange. They have contracted Maximus for two years to help them set up their digital exchange. According to the Star Tribune,  It is expected to launch in Fall 2013.

In Arizona,Chuck Coughlin and Peter Burns were hired to create a campaign in order to encourage the state government to approve Medicaid expansion. They unite the voices of hospitals, insurance plans, providers and other players.  Should the Medicaid Expansion be approved, up to 300,000 Arizona citizens will eligible for healthcare from the program.  According to the Tuscon Citizen, they argue that without the expansion, hospitals and doctors will continue losing patients who are uninsured and money from those who are not.

Maryland is a democratic state while neighboring state Virginia is republican, and the vast differences between their approaches to creating the health insurance exchange.  Virginia's governor Bob McDonnell has yet to authorize an exchange.  The District of Columbia began assessing it's options in Fall 2011, and plans thus far have not made decisions as to whether it will be an open or closed to all providers and will be mostly internet exchanged.  For more on the comparison of the three states and where they stand in the Exchange process, read the article at the Washington Post.

In Vermont, they're looking at their exchange as a bridge to what the state really wants to set up - a government run single payor healthcare system.  By taking the federal money to fund their current healthcare exchange, they're able to create that system - Green Mountain Care - which will open for business in 2017.  Read more about the plans for this exchange at the Heartlander.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!

Health Insurance Exchange Update: Wednesday, August 8, 2012

Oklahoma Flag

Setting up exchanges is a topic some legislatures do not want to deal with until the election. The name has even come under fire lately which will be explained further. But there are three states are setting up CO-OPs, California is having an issue with legislation that could hurt their exchange program, and Oklahoma seems to have been a victim of politics in the health care decision.

Tulsa World writes that Oklahoma, along with 28 other states, has decided not to set up their own exchanges. But the article tells that the legislature had every intention to set it up but they came under pressure from others not to set up the exchanges. But the state is looking at a possible expansion of Medicaid, sending letters to Health and Human Services Secretary Kathleen Sebelius with possible scenarios. 

In the west, three states are leading the charge with Consumer-Oriented and Operated Plans (CO-OPs). Allowed under the Affordable Care Act, CO-OPs are mean to stimulate more competitive rates for health plans offered through exchanges. Three states that are going forward with CO-OPS are Nevada, Arizona and Colorado. But there are questions about what would happen. If it is a success, then it could be a new sales channel for drug companies. But if it fails, costs could spiral out of control because CO-OPs cannot reject applicants and those applicants could possibly have expensive medical problems.

California has been leading by example, setting up one of the first exchanges in the country. But now there is news that this could be derailed somehow. Sacramento has legislation that would create a Basic HealthPlan. This will pose a potential threat to the California Health Benefit Exchange. The Basic Health Plan would take people who make less than two times federal poverty level out of the marketplace. It would put these individuals into a system that is run by the state’s Medicare called Medi-Cal. If this legislation is passed, it would rob about 40 percent of consumers and lose half of federal funding. The legislation is supported by public health plans, safety net providers and county workers. Those who oppose this legislation are private health plans and conventional provider network that would rather compete for consumers through exchanges.  But this plan would lead to more problems besides competition. The Basic Health Plan is affordable only because it pays doctors and hospitals less than their underlying cost for providing care. In addition to that, there could unforeseen financial risk. The amount of federal funding that would be needed for the plan will not be determined until the end of the year, which is when the state sets their premium costs. This could lead to overestimating and a difference that could lead to $500 million. 

Never mind the fact that states are still opting not to set up most of the Affordable Care Act, there are some contemplating actually changing the name of exchanges.  In an article written for the Wall Street Journal, the word exchange is said to “raise suspicion of loopholes.” So with that, other states are now trying to come up with different names like Washington may be leaning towards Washington Healthlink, and Minnesota with two options: Health choices and Minnesota Health Insurance. As long as the exchanges are being applied, the name seems to be a minor issue though to appeal to consumers it may have to be welcoming.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!

Health Insurance Exchange Update: Monday, August 6, 2012

Missouri State Flag

Despite the fact that a fight is waged against the new health care law, there are measures insuring what will be done on creating health care exchanges. Some states are voting for a consensus among the people, others want to get going but they do not have an idea of what the exchanges run by the government will entail and how much money will be used for the program. While others are standing, arms folded and refusing to play. Regardless, one way or another, the exchanges are going to be set up.

Missouri is so divided on the measure that there will be a vote to see if they should set up the exchanges or not. Though this news is a few months old, they are not even fighting over the exchanges anymore; they are still fighting over the wording of the referendum. The Washington Post reports that back in May, the General Assembly approved a ballot measure to set up the exchanges. The Republican-controlled legislature wanted to try and block Gov. Jay Nixon, a Democrat, from establishing the exchanges by executive order. But Nixon stated that he does not plan to do that. Now the language used on the ballot was deemed biased and inaccurate by Lt. Gov. Peter Kinder supposedly within minutes of its publication. So now not only will the people be voting for a president in November but also whether to set up exchanges. But the legislative body may be forgetting one thing: the federal government will set up their own exchanges.

With the bickering happening back and forth in Missouri, there are some states that are moving on in case the president remains in office.

The New York Times reports that the federal government will be covering more states than it had anticipating. The government will not have a one-size fits all exchange program set up, this will vary from state to state. But the article makes it clear that the federal government is not so transparent as other states. California, Mississippi, Minnesota, and Nevada have websites that show documents pertaining to their exchange marketplace. These documents show cost estimates, minutes of public meetings and information about goods and services.

The government, however, is vague about financing the exchange program and they have disclosed little information about their plans. This leaves officials like Thomas M. Hate, president of Landmark Benefits in New Hampshire, says that they have no idea what the federal government’s exchange will look like. He goes on to say that they have not been much communication between the state and federal officials.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate! 

Health Insurance Exchange Update: Tuesday, July 31, 2012

Wyoming State Flag

States are starting to meet with their task forces to figure out if they want to go forward with implementing the provisions in the health care law. Some states want to appear that they are at least giving an effort in figuring out what to do instead of hoping for that the president loses in the November elections. Others are starting to move ahead and implement the program to have it ready by November 16.

IBM announced that their Curam Social Program Management Platform will be used to verify the eligibility for the 1.2 million Minnesotans seeking health coverage. Minnesota, like other states, will rely on multiple technology vendors. Minnesota already agreed to a $41 million contract with Maximus to create the state’s health exchange website. IBM will work as subcontractors for Maximus in setting this up. The exchange program needs to have a robust infrastructure to support their websites where customers and businesses can compare cost online and get their own health coverage. Minnesota points out that they must achieve certification on their design and development of the marketplace by January 2013. And they hope to have the marketplace up and running by October 2013. To accomplish these goals set out to avoid a federally ran exchange program, IBM will also be working with two other subcontractors: Connecture, which is based in Wisconsin, will provide technical support the enrollment and sales function; and EngagePoint, based out of Florida, will provide financial management module for billing, aggregation, and payment reconciliation. The design of the exchange program will design information systems to see which individuals qualify for tax credits, Medicaid, or cost-sharing reductions. 

Wyoming is still mulling over what to do about health care. According to Billings Gazette, a group selected to figure out the options for the state are still left with one question: How can an exchange program work for Wyoming? Lawmakers told the Wyoming Health Benefits Exchange Steering Committee back in March to stop their work on an exchange program until the health care ruling. Since then, the committee is trying to get all the information possible and they are trying to get some information from the federal government. But some are expressing their frustration with the lack of information given to them from the government. Sen. Ben Laden said that over the last two years, they have been “shooting at a moving target” trying to get the right amount of information needed to make their informed judgment. The committee will meet in the fall. With this deadline, they are hopeful that this would give the Joint Labor, Health and Social Services Committee time to craft bills before their next session the following year. 

Idaho’s health care task force met to discuss the options going forward as well. Many leaders in Idaho are strongly against health care reform including Gov. Butch Otter. Nonetheless, they are still stuck on what their actions are going to be moving forward. One problem they are having is the inability to have credible numbers. Officials are having a hard time figuring out just how much money the exchange program will cost whether the state runs their own or the federal government steps in. In addition to being lost with exchange numbers, officials are unsure of the amount for a potential expansion of Medicaid. But there seems to be an overall agreement that even with those numbers, the minds are already made up about what to do with the provisions in this health care law.

Though states have their own prerogative, a union president voices his opinion on the idea of universal health care. The president of the Wisconsin Farmers Union argued that "rural residents often have the hardest time getting health insurance." People in these areas mostly are self-employed and have their own small businesses. They often pay way too much money on their coverage, so with this bill, it could help those who are self employed pay less for health insurance.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate! 

Health Insurance Excahnge Update: Tuesday, July 17, 2012

Ohio State Flag

States are beginning to set up their exchanges to meet be prepared in case of another four more years of the current president. But while some are more open, others have gotten some backlash even when they receive federal grants for the exchanges.

Ohio recently received $1 million from the federal government and then is receiving some backlash. According to the Columbus Dispatch, Supporters of the health care law are saying that Gov. John Kasich’s administration is playing politics with the taxpayers. However, the governor previously stated that the state will take the federal option because it would cost less. 

Minnesota reached an agreement with a Virginia-based firm Maximus firm to design health insurance exchange. According to Minn Post. The agreement will total $41 million. Maximus will be responsible for developing the technology to support the exchanges. Maximus will also include elements like eligibility determination, account determination, and health provider information. In addition, the contract instructs Maximus to improve the technology for Medicaid. The Commerce Department says that the exchange will help lower premiums, provide coverage for 300,000 by 2016 and significantly expand federal Medicaid coverage. But Republicans in the state are wondering whether the exchanges will produce any good that the governor’s administration says will happen. They also wonder whether an exchange can be implemented without legislation approval. The contract is expected to run through 2014 but that could continue. Commerce Commissioner Mike Rothman said that the state actually got a great deal to set up the exchanges. 

California wants to make buying health insurance easy. According to the Sacramento Bee, Peter V. Lee, head of the California Health Benefit Exchange, wants buying health insurance to be equivalent to “buying a book to Amazon.” He envisions that in 15 months, uninsured California residents will log onto computers to shop for their health care. The plans will have the “platinum” plan which has higher premiums to “bronze” plan which offers lower premiums. The exchanges are expected to reach 2 million uninsured people by 2019. California now is trying to figure out ways to get people using the exchanges. The exchanges are set to have people registered by October 2013. To get people insured, they have thrown around ideas such as having ads in English and Spanish, banners on Facebook, and have churches distribute literature. But, they also want to go even more outside the box. They have an idea of pitching to popular television like “Modern Family” and incorporate healthcare changes in story lines.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!  

Health Insurance Exchange Update: Wednesday, July 11, 2012

Nevada State Flag

Today, the House will vote on repealing Affordable Care Act. This will not be the first time the House has voted to repeal this according to the Washington Post. This has occurred 32 times already, this will be number 33. There are however those in state offices who are electing to take action or gather all the information to figure out the full implications regarding the exchange marketplace.

The letter sent to 12 Senators and 61 House Members minutes after the health care law was upheld was signed by those who opposed it, Nevada elected not to sign the letter. As one of the 26 states that challenged the constitutionality of the law, Nevada will go ahead and begin to set up health insurance exchanges. Gov. Brian Sandoval moved forward with implemented the law his first day in office back in January of 2011. The governor expressed some concern over the constitutionality of certain parts but he realized that as long as the law is enacted, there were deadlines to meet. Nevada was awarded approximately $24.7 million in grants for to set up the exchanges. Nevada’s exchange is set to be operational by October of 2013. 

Gov. Mark Dayton of Minnesota sent a letter to Republican legislators to ask them to participate in helping create health insurance exchanges. However, a key senate leader wants to wait until the November election to begin implementing the provisions in the healthcare law. Gov. Dayton wants to urge state officials to act on this provision now or they will be forced to having to use exchanges set up by the federal government. But there are still proponents of the bill who want answers. Sen. David Hann wants to know how this is going to be affordable. Sen. Hann believes that exchanges will cost anywhere from $300 million to $400 million per year. Regardless of the opposition, the governor will be trying to move forward. 

Idaho Gov. Butch Otter wrote an op-ed piece sent out to various media outlets explaining that he will get all the facts about the exchanges before he does anything. He does not want to join other GOP governors who will continue to fight against the law and hope for a Mitt Romney win in November. But as Otter expressed in his piece, he wants to do what’s best for his constituents. 

Maryland’s governor, Martin O’Malley, is on track to establish the state run exchanges according to Youth Today. The early action taken by the governor has led to the creation of Maryland Health Benefit Exchange as a public corporation back in April 2011. Maryland Legislature approved policies for the state run exchanges. 

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate! 

Health Insurance Exchange Update: Friday, June 28, 2012

Minnesota State Flag

Many states were delaying their decision on whether or not to build a health insurance exchange until the ruling on the Supreme Court.  With the decision handed down yesterday that the whole law in indeed constitutional, states will now have to decide whether or not to create their own state run exchange or rely on the exchange set up by the federal government.  So where do states stand?  Over the next few weeks, we'll find out who will go with a state run exchange.

For now, here is where some states stand after the ruling:

Colorado had already begun building a state exchange. Repbulicans in the state belive the ruling was truly a good thing for their state.  Their Colorado Benefit Exchange is set to launch in October 2013.  According to Bloomberg Business Week, 13% of the state is currently uninsured.

Montana was one of the states who declined to join the others who brought the law suit to the Supreme Court.  The state believes it has done the right thing, and as a result has continued to work with the federal government in order to make an exchange for its citizens.  Bloomberg Business Week states that their private insurers now have a deadline of next fall to submit their policies that will be available on the exchange to the uninsured citizens of their state.

Minnesota will also be moving ahead with it's health insurance exchange.  Their governor Mark Dayton began building the exchanges in 2011.  It is expected that they will move full steam ahead according to MinnPost.  A 15 member task force has been working together to develop the blueprint for the state, which they will have completed by 2014.  A compelete timeline of this rollout can be found here.  And the letter sent by Minnesota Healthcare Leaders about the exchange can be read here.



New Jersey's Governor Chris Christe has stated he will still not start the creation of a health insurance exchange.  He believes that if there is a change in ruling from the Presidential office, there will no longer need to be a health insurance exchange.  Bloomberg Business Week also states that Christie will comply with any hard deadlines that are set forth by the government.

Nebraska's sentiments are much the same.  Governor Dave Heineman will be further looking at the law and decide what it means for Nebraskans. He will also keep in mind that many things could change if Mitt Romney is voted into office this coming November.  Read more at Omaha.com.

South Dakota's Governor Dennis Daugaard follows suit with Nebraska and New Jersey, stating he has no intention in starting an exchange without fully analyzing all parts of the law.  He will protect South Dakota from the harmful pats and believes that things could change after the November elections.  CBS News states that in 2010, the state had 10% of the population that was uninsured.

To get ahead of the game, join us this November to learn more about creating exchanges.  The Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  For more information on this year's agenda, download the program here.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!

Health Insurance Exchange Update: Monday, June 4

Many states are preparing to implement health insurance exchanges.  With the final word on the Supreme Court hearing due out later this month, states are taking different approaches on how they're working with their exchanges.

• In California, Accenture was given $359 million to build an online eligibility and enrollment system for for the exchanges.  With enrollment set to open October 1, 2013, they are contracted to both build and maintain the system after the health insurance exchange is open for business according to iHeartBeat.


• In New Hampshire, the House sided with the Senate to block the start of developing an insurance system.  They've done so in part because they believe that the ACA bill would not allow for enough communication between the New Hampshire Department of Insurance officials and the federal government for the creation.  There also wouldn't be enough input from the tax payers, who would ultimately be funding the project according to the New Hampshire Watch Dog.


• In Minnesota, they believe that even if healthcare reform doesn't stand in front of the Supreme Court, it's still at the top of their minds.  They see technology as the key to make healthcare reform possible.  Due to healthcare innovation in the state since the 1990s, they believe they are ahead of the curve.  Insurance companies, doctors and hospitals have all begun working together to breakdown the barriers of previous healthcare programs.  Locals in the state do look forward to the clarity that it will bring to insurance availability through small businesses according to the Star Tribune.

This November, the Health Insurance Exchange Congress will be held November 13-14, 2012 in Chicago, IL.  Here, state officials and health plans with the only opportunity to come together to discuss PPACA and strategize on how to make this a successful opportunity for all.  As a reader of this blog, when you register to join us and mention code XP1710BLOG, you'll receive 15% off the standard rate!