Health Insurance Exchange Board Hammers Out Choice, Communication Issues
July 18. 2012 -- The Health Insurance Exchange Board intends to launch an aggressive communication campaign next summer and encourage people to purchase insurance so they can avoid paying a penalty starting in January 2014 when the Affordable Care Act kicks in.
Each insurer will be limited to three health plan options in the individual and small group market, which should avoid confusion, Rocky King, executive director, told the exchange board last week. Massachusetts learned that lesson the hard way, he said, and ended up dropping plans after implementing a statewide insurance mandate.
To help people realize they’re eligible for subsidies to help defray the cost of insurance, the exchange’s website will include an income calculator.
The exchange board agreed that PacificSource should have the distinction of having the “essential health benefits package” offered to individuals and small businesses in Oregon and be known as the bronze plan. The purpose of an essential health benefits package is consumer-driven – to ensure that every insurance plan includes a basic level of coverage.
Regence Blue Cross Blue Shield and Kaiser Permanente were also under consideration but were considered too expensive, according to Dr. Jeanene Smith, administrator of the Office of Oregon Health Policy and Research.
In addition to the benefits offered by PacificSource, there will also be supplemental coverage for pediatric vision, pediatric dental, prescription drugs and habilitative services.
“The place where I have the biggest concern is where that floor gets set,” said Liz Baxter, who chairs the Exchange Board, adding that she’d like to see the “floor” for coverage set high enough to justify costs.
“Those costs may be different than what we may be able to think,” she added. “How do we get to the point where the floor is high enough that I'm not petrified?”
“In 2014, premiums are going to be significantly higher,” King said. “How much, I don't know.”
“A piece of information I’d find really helpful is whether the plan is equal to what you’d receive with Medicaid,” said Aelea Christofferson, a Bend business woman. Prior to getting involved with the health reform movement, she was unaware that some low-wage employees might receive better coverage through the Oregon Health Plan rather than from an employer-sponsored plan.
“I’d hate to have employers say, 'I'm going to do the best I can for my employees, so I'm going to drop their coverage so they can get Medicaid,” she added.
Christofferson also wondered whether the number of choices of health plans could be overwhelming for some people shopping for insurance on the exchange website – unless, she said, there was an income restriction or another filter in place.
Depending on where someone lives, people could choose from up to 140 different health plans, said King, who predicted that people in the Portland metropolitan area could expect to have many more options than those in rural communities.
“There are two issues here. One is too much choice. Another is adequate choice,” said Dr. Bruce Goldberg, director of the Oregon Health Authority.
King echoed this sentiment but said he was also concerned about people having adequate networks of providers in their areas.