Enrolling Healthy People a Likely Challenge for Calif. Health Exchange

A significant challenge for state officials implementing the California Health Benefit Exchange will be to draw enough healthy individuals to the exchange to keep prices down and provide enough income to health insurers, the Sacramento Bee reports.

  • According to the Bee, if the exchange attracts only high-cost patients, insurers might not participate (Yamamura, Sacramento Bee, 7/17).

About the Exchange

The federal health reform law requires states to launch online insurance marketplaces by 2014.

The California Health Benefit Exchange primarily will serve individuals and small businesses. An estimated 4.4 million California residents are expected to use the exchange by the end of 2016 (California Healthline, 6/13).

Officials plan to open registration for the exchange in October 2013.

Attracting Healthy Individuals, Insurers to Exchange

According to a report, exchange officials are planning a large public outreach effort next year to entice healthy residents, which could include:

  • Advertisements in various languages;
  • Banners on social networking websites; and
  • Literature distributed through churches.

In addition, officials are considering:

  • Hosting a health care summit with first lady Michelle Obama;
  • Recruiting celebrity spokespeople; and
  • Working with popular television shows to incorporate health care changes into their story lines.

Diana Dooley — California Health and Human Services Secretary and a member of the exchange board — said, “We’re doing a lot of work at the exchange to understand what motivates people” to seek health insurance through the exchange, as well as their concerns with doing so.

Meanwhile, Marian Mulkey — director of the Health Reform and Public Programs Initiative at the California HealthCare Foundation, which publishes California Healthline — said that the exchange is “an important new channel” for insurers to sell health plans. However, she said, “[I]t doesn’t mean they will all arrive with the same enthusiasm, wanting to participate.”

Charles Bacchi — executive vice president at the California Association of Health Plans — said that to maintain reasonable risk pools, “it’s important that the exchange and outside marketplace look alike.”

Federal Funding for the Exchange

Meanwhile, health care advocates have acknowledged uncertainties about federal funding for the exchange. Although the U.S. Supreme Court ruled last month to uphold the health reform law, Republicans have indicated they will seek to repeal the law if they win the White House and Congress in the November election.

Anthony Wright — executive director of Health Access California — said, “The real risk to the exchange is the loss of the [federal] subsidies, which would be a real attraction for millions of Californians.” He said the exchange could work without the subsidies, “but it wouldn’t be as attractive to as many people” (Sacramento Bee, 7/17).

 

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