Health exchanges move forward in state

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Colorado’s still in front of the pack when it comes to implementing its health insurance exchange, known as Connect for Health Colorado. It’s one of a handful of states nearing the finish line as it prepares for a marketing push to begin selling health insurance policies in October.

“Colorado really is leading the rest of the states — we’re farther down the road to creating the exchanges,” said Dede de Percin, executive director of the Colorado Consumer Health Initiative, a health care advocacy nonprofit that’s been involved in the creation of Connect for Health Colorado. “But there’s still some work to be done — we still have to find out the details of the plans and to let people know how to access the exchange.”

Altogether, 17 states and the District of Columbia have opted to set up their own exchanges, and six states are pursuing partnership exchanges. The other 27 states will default to a federal exchange program. The exchanges are part of the Affordable Care Act, popularly known as ObamaCare, designed to give people more access to health insurance. The exchange is the only place to apply for federal subsidies for premiums.

In Colorado, state officials have been on a hiring spree, announcing a call center in Colorado Springs that will employ more than 200 people. They also are providing money for local organizations to hire and train new staff members to direct people on how to use the insurance exchange.

In El Paso County, those assistance centers are Peak Vista Community Health Clinics, Pikes Peak Area Council of Governments, Tri-Lakes Cares and the Community Partnership Family Resource Center. The roughly 58 organizations chosen statewide by Connect for Health Colorado will share about $17 million to train workers to help people access the new virtual health insurance marketplace.

More good news: The sequestration legislation hit the exchange federal grants only lightly — reducing the second-stage grant from $125 million to $116 million for the next implementation phase. And the exchange is working on a series of strategies to become financially independent of state, federal or local money by 2015.

“We’re on pace and on target to open in October,” said Ben Davis, spokesman for the exchange. “We’ve focused on training the navigators, and we’ll be launching a huge education effort in August and September.”

The state organization has hired officers and started the technical work to operate the exchange, Davis said.

“We’re not quite ready to announce the funding system,” he said. “It will be a system of fees to use the exchange, and some other items to make sure we’re independent by the deadline. “What you’ll see in the future — the call center will open and there will be big education events at places like the State Fair to let people know the options.”

The exchange itself won’t be the only group advertising the changes due in January from the Affordable Care Act. The Centers for Medicare and Medicaid Services will be launching an advertising blitz, as will the Department of Health and Human Services.

Even CCHI is promoting the health care exchange, and changes to make insurance more affordable for small businesses.

“People don’t realize that small businesses now have a tax credit of 35 percent if they offer health insurance,” she said. “That goes up to 50 percent next year, and lasts for the next two years.”

Some groups are concerned that not enough money has been allocated to local organizations to educate people about the exchange and how to navigate it. But most health care advocates are pleased with both the progress and the promise of the exchange.

Between 125,000 and 150,000 of the currently 800,000 people in the state without insurance are expected to sign up in the first six months of the exchange. An additional 160,000 people will be eligible for care under the new Medicaid expansion that’s launching at the same time, while 40,000 are expected to sign up under the current Medicaid requirements, thanks to more information about the program.

As for the rest? De Percin says they’re a mix of people.

“Some of them fall under the affordability exception, or people who can’t afford insurance on the exchanges,” she said. “There are people who are exempt because of religious reasons, and there’s a transitional group — people who don’t have insurance because they’re in between jobs or waiting to go to school. Some are undocumented. And then there are the holdouts, the freeloaders.”

A number of people won’t get insurance no matter what — and those are the people who concern de Percin.

“We all have to pay for them, because we’re not a brutal society,” she said. “If someone without insurance gets in a car crash and their care is $500,000, we take care of them. Then that cost is shifted to people with traditional insurance, and premiums go up.”

That’s why the exchanges are important — the bigger risk pool should lower insurance premiums over time, she said. The state’s Division of Insurance has approved 150 new products and plans in the individual market and 93 in the small group insurance market for the exchange.

“It’s going to be a robust market, there’s no doubt about that,” she said. “And it’s going to make a difference to small businesses and individuals that many people don’t yet realize.”