Latest Grant Helps California Health Exchange Plan Move Forward

The Sacramento Bee –

January 18, 2013:

Bolstered by a federal grant of $674 million on Thursday, Covered California outlined an agenda to keep the state health exchange on pace for a full-scale launch on Jan. 1, 2014.

California’s nascent health-insurance shopping site faces a complex and expensive ramp-up process as it seeks to sign up customers from throughout the state’s diverse communities.

Officials Thursday laid out an action plan for outreach that includes signing up translators fluent in the 13 languages common in the Golden State.

Because California’s land mass is so huge, Covered California expects to develop seven geographical exchanges reflecting different markets in Sacramento, Northern California, the Greater Bay Area, the San Joaquin Valley, the Central Coast, Los Angeles and the rest of Southern California.

Covered California executive director Peter Lee noted at the organization’s monthly meeting Thursday that development of the exchange may not always go smoothly.

“We will get things wrong as we go,” Lee said. “But we will make them right as quickly as we can.

“Fifty years ago, Medicare was launched,” Lee said. “We have to think of the long view and believe we will be around for a long time to come.”

In the months leading up to next New Year’s Day, Covered California will use some of the new federal funds to develop a fully operational Web portal where consumers can shop for insurance policies.

Before that, though, the organization will have scoured health plans to find those meeting its standards for quality.

The goal is to eventually offer consumers apples-to-apples comparisons of health plans for purchase on the exchange’s website.

With Thursday’s infusion of federal funds, Covered California will have received nearly $1 billion in federal grants – starting from the first $1 million startup grant in 2010 when California became the first state in the nation to jump aboard the federal Affordable Care Act.

By the year 2015, the exchange must be self-sufficient and able to sustain itself financially.

To that end, Covered California is looking for donations from community volunteers, houses of worship, foundations and philanthropists to help its bottom line.

When it comes to signing up an expanded population for Medi-Cal, outside funding will have to be found since the state budget is off-limits for such uses.

As for the structure of the overall product, a recent report to the governor and Legislature reveals that Covered California is moving forward with a decidedly simple concept in its plan to hook consumers.

Call it, prosaically, the “metal level” plan.

The report explains: “Every insurance policy offered inside and outside the Covered California marketplace will be given a ‘metal rating’ – platinum, gold, silver or bronze – based on ‘actuarial value’ calculations.”

In other words, if you want to buy insurance through the state’s health exchange, you’ll be able to choose among a platinum rating for 90 percent coverage; gold for 80 percent coverage, silver for 70 percent coverage, or get frugal and go for the bronze plan for 60 percent coverage.

If you settle on the bronze, mind you, you’ll have to pay 40 percent of the costs out of pocket if you get sick. Conversely, a platinum plan leaves you picking up the tab for just 10 percent of your bill – but you’ll likely pay quite a bit more overall for the policy.

Source: John & Rusty Report via Choice Admin