July 24, 2012: In the wake of the U.S. Supreme Court’s decision upholding the Affordable Care Act, California’s first-in-the-nation Health Benefit Exchange is redoubling its efforts to enroll as many as possible of the estimated 3 million people who will be eligible to buy insurance through the state-run purchasing pool that will open for business in 2014.
Board member Kim Belshé, former secretary of the state Health and Human Services Agency, told attendees at a health care policy briefing on Tuesday that the goal will be to give those who buy policies through the Health Benefit Exchange the same purchasing leverage that large companies now have when contracting for group coverage for their employees.
“We’re trying to get millions of individuals and small businesses the same kind of power that large businesses have,” she said. “We’ll provide a gateway to affordable coverage. There is an opportunity to use our purchasing power to improve quality, to improve affordability and to improve disparities in health care.”
Belshé spoke at a briefing sponsored by the Greenlining Institute, a Berkeley-based nonprofit focused on expanding access to health care in minority communities.
Under the federal health care reform law, each state can establish purchasing exchanges through which individuals and small businesses can select from a menu of private health insurance policies that meet minimum coverage standards. Individuals will still be able to buy directly from companies or through private brokers, but only those who buy through the exchange will be able to access government subsidies that will be available to those with incomes of up to 400 percent of federal poverty guidelines, or about $93,000 a year for a family of four.
Belshé said one of the challenges faced by those implementing the law is to educate consumers about the options they will have available and to “cut through the clutter of misinformation and outright myth that surrounds the Affordable Care Act.”
She noted that while the exchange will have a potential customer base of about 3 million, it will still represent only a small fraction of Californians. About 80 percent of state residents will continue to receive coverage through either employer-based insurance or government programs and another 10 percent will be ineligible for a variety of reasons, including lack of citizenship.
For the rest, the exchange will provide access to insurance that is now either unavailable because of pre-existing health conditions or out of reach because of its price.
“It’s not about the individual mandate. It’s about affordability,” she said of what will motivate the exchange’s customers. “People want to buy insurance.”
Officials at the exchange anticipate that most sales will take place through an online marketplace that Executive Director Peter Lee has said will strive to make purchasing health insurance “as easy as buying a book on Amazon.” In addition, Belshé said the exchange will partner with “tens of thousands” of individuals such as county eligibility workers, staff members at community health clinics and private insurance brokers to assist people in purchasing subsidized coverage.
Source: The John & Rusty Report via Word & Brown