California’s Health Benefit Exchange will open for pre-enrollment in a little more than a year and a half. But this isn’t “Field of Dreams.” Even though California has built its exchange, it’s not enough to just hope or expect folks to come and sign up for health insurance.
The exchange and its many public and private partners must make the compelling case for why people should purchase coverage.
In order to successfully attract and enroll millions of eligible Californians, the exchange will need to effectively execute three key implementation tasks in the next year:
1)Â Â The sales and marketing message. What will compel millions of individuals to enroll and actually pay premiums (even if subsidized) for a product they have previously gone without? A pitch will need to condense three simple but not always easy facts about the law:
a.Â Â You may be eligible for free insurance or deeply discounted insurance.
b.Â Â Health insurance will help keep you and your family physically healthy and avoid financial hardship.
c.Â Â You must have health insurance. It is the law and there are financial penalties for not complying.
This message will need to be delivered not just from a marketing campaign but from trusted sources of information, including community-based organizations, health plans, insurance agents, community clinics and providers working directly with individuals to help them enroll.Â Â
2)Â Â The product. What is being offered? A core feature of the exchange is the opportunity to choose among participating health plans whose prices, benefits, quality of service and provider networks are transparent and understandable. In order to attract customers, the exchange must offer affordable options that provide comprehensive benefits and a choice of health plans –Â including statewide commercial plans, regional plans and safety-net plans that have experience and a high standard of quality — to lower-income populations.
3)Â Â Eligibility and enrollment. How easy will it be for individuals to establish eligibility and how quickly can they enroll? The exchange, Medi-Cal and Healthy Families programs must have a transparent eligibility system and a consumer-focused enrollment process. There must be specific metrics and standards, such as call waiting times, after-hours enrollment, and turnaround times for application completion and processing.Â Whatever entity is performing these functions must publicly report their results and be held accountable for high customer service standards.
These are not easy tasks, but together we have the opportunity to cover millions of uninsured Californians and to begin the process of lowering the cost of health care.Â That would be a great ending to our movie.