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February 14, 2014 at 08:46 AM
State-based exchange boards are still poring over plan enrollment charts, but they’re also spending more time on budget and operations presentations.
Some of the exchange programs that held board meetings this week include the District of Columbia Health Benefit Exchange Authority, Minnesota’s MNsure, Nevada’s Silver State Health Insurance Exchange, and Cover Oregon.
A few months ago, many state-based exchange boards focused heavily on picking website names, fine-tuning exchange plan benefits requirements and addressing demands for translating their websites into Chinese, Russian and Navajo.
Now, the boards are thinking more about the Patient Protection and Affordable Care Act exchange program “sustainability requirement.”
In 2014, exchanges can use federal grants to pay for everything but their navigator programs. But by 2015, exchanges are supposed to support themselves.
In Oregon, where the exchange website is unable to take coverage applications online, the staff has struggled to use paper applications to enroll nearly half of the 50,000 uninsured state residents who’re eligible for private-plan subsidies in private qualified health plans.
Oregon exchange managers want to pay for the exchange in 2015 with a $6.95 per member per month assessment on Medicaid and other public health programs that enroll people through the exchange, and a $9.38 per member per month administrative charge on QHP enrollees.
Because web problems have hurt enrollment, exchange managers are preparing to cut their $60 million 2015 budget by $10 million. The exchange would get about half of the savings by cutting the old $7.5 million communications and outreach allocation to $2.7 million
The District of Columbia is getting good QHP enrollment totals for DC Health Link, in part because Congress is having its members and many of its own employees get coverage through that exchange.
D.C. managers want to create a broad-based assessment that could affect all health carriers — even those in the Medicare supplement market and other markets outside the major medical universe — with more than $50,000 in annual gross receipts.
