Covered California on Track for Open Enrollment, Audit Finds
California's health insurance exchange, created under the Affordable Care Act, is on track to be ready to open for enrollment on Oct. 1, according to a report by state Auditor Elaine Howle, the Sacramento Bee's "Capitol Alert" reports (White, "Capitol Alert," Sacramento Bee, 7/22).
Background on Exchange
The exchange -- named Covered California -- primarily will serve individuals and small businesses.
An estimated five million people will purchase plans through the exchange in 2014.
The state estimates that up to 200,000 small business workers and their dependents will get coverage through the exchange's market for employers with 50 or fewer workers (California Healthline, 7/22).
Findings of Audit
According to the report, "Covered California has made great strides in implementing key federal and state requirements pertaining to the exchange's establishment and operation."
The report found that:
- Oversight and governance of the exchange "appear adequate;"
- The exchange's outreach plans are more than adequate;
- The exchange board has adopted several conflict-of-interest and financial disclosure policies that align with federal requirements; and
- The exchange has publicly released contract details despite a statutory ability to keep such information confidential.
However, "hiring challenges" at service centers in Contra Costa, Fresno and Sacramento counties could delay call center implementation, according to the report.
Meanwhile, the report noted that the future solvency of the exchange depends largely on the success of an enrollment campaign and whether state residents actually sign up for coverage. Because of this uncertainty, the exchange has been added to the auditor's list of high-risk state issues.
The report noted that an additional in-depth independent audit will be necessary to further evaluate the exchange's financial controls.
The report recommends that Covered California:
- Formally adopt a policy to keep contracts, contract amendments and payment rates confidential only in cases when it is necessary to protect the exchange's future contract negotiations;
- Develop a policy and action plan for monitoring, recertifying and decertifying qualified health plans; and
- Conduct regular reviews of enrollment, costs and revenue.
Howle said Covered California agreed with the report's findings and will implement its recommendations (Central Valley Business Times, 7/18).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.