State-Run Exchanges Credit Smaller Size, Better Focus for Success
Officials overseeing some of nation's most successful state-run health insurance exchanges on Friday said their marketplaces are equipped to quickly address and resolve any glitches that arise, The Hill's "Healthwatch" reports.
Speaking at a briefing at the National Press Club in Washington, D.C., the officials -- from California, the District of Columbia, Kentucky and Rhode Island -- said they were able to avoid the protracted challenges that HealthCare.gov faced because their state exchanges were comparatively smaller and more focused on their constituents' needs.
Christine Ferguson, director of the Rhode Island Health Benefits Exchange, said the state-run exchanges "can be so much more effective than [the] federally run system" because "[e]very state has a different market, so each of us comes at it from a different perspective."
Ferguson added that exchanges "like ours are really going to be able to use this investment very effectively and be a catalyst for overall change." According to "Healthwatch," Rhode Island met its 2014 enrollment goal in early January.
Audrey Haynes -- secretary of the Kentucky Cabinet for Health and Family Services -- credited her state's strong enrollment figures to the state's centralized structure, "Healthwatch" reports. One agency has been designated to oversee Medicaid, the health and family services department and other health advisory boards. "We don't have as any many structural barriers," she noted.
Haynes also said that smaller state-run exchanges allow insurers and exchange staff to work together more easily to address constituent concerns. "We're looking out for people in much more intimate way," she said, adding, "That's not something you get in a much larger system."
Meanwhile, Heather Howard -- director of the State Health Reform Assistance Network -- noted that states operating their own exchanges have about $200 million for outreach and enrollment efforts, while states using the federal health insurance exchange website have only about $50 million (Easley, "Healthwatch," The Hill, 1/31).
Officials Highlight ACA Concerns
The state officials also expressed concerns that certain underlying issues in the ACA could undermine their states' successes, Modern Healthcare reports.
Ferguson listed several "fundamental problems" with the law that need to be "cleaned up" or there would be "ramifications" over the next few years. She said some individuals who should be eligible for federal subsidies were unable to access those tax credits because of affordability standards under the law for employer-sponsored health plans.
Ferguson added that some Medicaid-eligible individuals might not want to enroll in coverage, even when they already are ineligible for the subsidies to offset premium costs in an exchange.
Meanwhile, Mila Kofman -- executive director of the D.C. exchange -- said that the federal identity verification system is "very difficult" to get through quickly, which could be losing consumers (Demko, Modern Healthcare, 1/31).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.