Insurance Exchange Board Member Have High Hopes, and Many Concerns

Accessibility to clear information and flexibility in picking plans, board members say, will be key to attracting enrollees
The Lund Report

September 29, 2011—Accessibility of information and increasing options for individuals and small businesses seeking affordable health insurance are among the many concerns the newly appointed board members to Oregon’s Health Insurance Exchange have on the eve of their first meeting Friday in Portland.

“The board is going to have a lot of really important issues facing it,” said Theresa Miller, the Oregon Insurance Division’s director, who sits on the exchange board as a voting, ex-officio member.

Some of those issues include crafting a business plan, overseeing the construction of the website that consumers will use to purchase insurance, determining how to attract people to the exchange, appointing a community advisory group, and working with insurance companies to design health plans.

The exchange, which was created this year with the Legislature’s passage of Senate Bill 99, will provide a one-stop shopping place for individuals and small businesses to find affordable health coverage in 2014.

The hope is that, through a website, those individuals and small businesses can compare multiple health plans, and find the plan that is not only affordable, but fits their health needs.

Key to the exchange’s success, board members say, is the website. “The ease with which you can [purchase health insurance] through the exchange will be a driving force,” said Aelea Christofferson, owner of Bend’s ATL Communications who represents small business interests on the board.

The information included will be specific for each health plan, including the monthly premium, the benefits, deductibles and co-payments.  

“Insurance is very complicated,” Miller said, and if the website doesn’t make it understandable to consumers, it may actually deter people from joining the exchange. “You can have the best information on your website, but if people can’t find it, it doesn’t do a lot of good.”  

Another issue is making certain the exchange is flexible enough to meet the needs of consumers by offering a variety of health plans. Christofferson, who provides coverage for her six employees but not their families, said that finding affordable insurance that suits all of her employees has always been difficult, and she can only offer one plan for everyone. “It’s unworkable,” she said. 

If marketing and recruitment efforts don’t enroll large numbers of people when the exchange gets under way in January 2014, “We would have a very difficult situation,” said Jose Gonzales, the owner of Tu Casa Real Estate, a small business, who’s been appointed to the board.

Christofferson said some elements of the exchange will “automatically populate” people to it, such as tax credits. But the board cannot be passive about recruitment, she added. “What we need to do is develop a system that is so good that people will want to be on the exchange.”

Gonzales said it’s important to find a way to reach people living in rural areas and those who lack access to the Internet. “I see my role as being able to deliver the message to as many people as possible,” he said.

Perhaps the biggest elephant facing the exchange is adverse risk selection which could occur if healthier people drop coverage to purchase a less expensive policy, which could lead to higher costs for those people who remain on the plan.

The exchange’s first big hurdle is gaining approval of its business plan from the Legislature in February. “We’re under some tough time frames,” said Rocky King, the exchange’s interim executive director.

But as the board gets cracking on the multitude of issues it must accomplish to gain such  approval, the nine board members do have a laser focus in their favor.

As Miller said, “it’s got to be really focused on the consumer.”

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Following the release of regulations by Health and Human Services, 8 key questions still remain about state healthcare exchanges.