As the new public health insurance exchanges come to life, the learning curve remains a long, windy road toward smooth running. The history of health reform has been filled with surprising twists. In California, for example, the governor signed a “play or pay” employer mandate bill into law in 2003 – then employers succeeded at going to court to block the law.
At the federal level, Republican leaders have been fighting implementation of PPACA with lawsuits, repeal bills and de-funding attempts ever since the act was signed into law in 2010.
See also: PPACA: A history
Contractor representatives testified at a House hearing Sept. 10 that the federal exchanges would be ready to open Oct. 1. Republican participants struggled to keep themselves from rolling their eyes.
Exchange managers in some states were celebrating the release of what they said were great exchange plan menus as regulators in other states complained about exchange plan premiums.
Exchange backers and critics also have their own enrollment projections. The Congressional Budget Office has estimated that the public exchanges could enroll 7 million consumers in 2014. However, USA Today reported that the exchange builders are predicting that enrollment will be far higher.
The exchange critics have wondered whether the exchange managers will “fill the room.” They’ve pointed out that another PPACA program — the Pre-existing Condition Insurance Plan (PCIP) — attracted only 105,000 of the 200,000 people originally expected to enroll. Even worse, it seems much of the uninsured public is ignorant to how an exchange operates and what it will offer. The Kaiser Family Foundation found in August that 43 percent of the uninsured adults it polled had heard nothing about the exchanges.
As we were trying to plan an article that could stand up against startling twists in the PPACA story, we decided to look at what benefits professionals have been seeing out in the implementation field.
To shape the story, we considered many metaphors: The opening of a Broadway show, a ship setting sail, a game of chutes and ladders, with the players often falling into a pit of snakes. We finally went with “trail blazers” — the people who brave mud, rocks and bears to let others know what might lie ahead and, even more important, how they are coping. Here, we give you the top five strategies industry professionals have embraced as the health care exchanges open.
Many individuals, employers and even brokers are still scratching their heads when it comes to PPACA and the exchanges. Which are private? Which are federal? Do I qualify? What will the plans cover? Is it expensive?
You get the point. And as we know, the only way to combat ignorance is with education.
“Right now, it’s all about education for the parts we do know and understand,” said Robert Crisan, a senior vice president at Hylant, an insurance, risk management and consulting firm. “ACA is affecting — and going to affect — everyone differently so there is no one right answer or solution for everyone. That freedom of choice, while good for consumers, creates confusion because they have to make coverage choices based on their own personal and family situations.”
Many brokers have been preparing for the Oct. 1 open enrollment period for months — even years — with the focus for many being PPACA literacy.
“Three words sum up the preparation we have done for open enrollment in the exchange: inform, inform, inform,” said Diana Twadell, a principal at Barney & Barney. Twadell makes sure she and her staff continue to read the most up-to-date information coming out of Washington, D.C.
For small businesses, Tradwell has been educating employers about the “Renew Early” option, which will move their renewal date to Dec. 1, 2013, and allow current plan and rate structures to stay in place until Dec. 1, 2014. Additionally, her group has been working to educate small employers about SHOP, which, in some states, enables small businesses to offer their employees a choice of carriers and plan designs, along with the PPACA federal tax credit, which can provide tax credits of up to 50 percent of the employer’s premium contribution for those employers that are eligible. “Ongoing education and an understanding of the changes on a day-to-day basis is critical, both leading up to and after the open enrollment period,” said Twadell.
One of the roles of brokers during this time is to keep clients in compliance. “This starts with our legal team reading and deciphering the regulations, so we can provide tools, seminars, webinars, communication and guidance to employers, both large and small,” said Twadell.
See also: 10 things to know about state health insurance exchanges
The importance of relationships is a critical aspect to just about every business in every industry. Without them, there are no clients and, thus, no revenue. The same goes for relationships under the PPACA umbrella. The communication needed to build them — and keep them — became a critical tool as agents prepared for Oct. 1.