Health Insurance Forum

California’s Health Insurance Substitutes

by mahir on 14/06/10 at 8:15 am

One of the most significant provisions contained in the new federal healthcare reform legislation is the establishment of health insurance exchanges designed to provide consumers greater choice and affordability. The legislation mandates that each state launch such exchanges by January 1, 2014.
Now, a new white paper released by the nation’s leader in developing and administering California health insurance exchanges says that Californians will be best served and the goals of universal coverage best achieved if the state harnesses existing enrollment channels and commercial marketplace infrastructure in a bold new public-private partnership. According to the paper, employing such a strategy will allow California to enroll as many eligible persons as possible with the least possible disruption to individuals or employers.

The white paper is the product of Administrators, which has been successfully operating such exchange models since 1996. Its flagship product is America’s oldest and most respected health care exchange for the small and mid-size employer market. Participating in California Choice are Anthem Blue Cross; Health Net; Kaiser Permanente; Sharp Health Plan; Western Health Advantage; and numerous leading dental, vision, chiropractic and related ancillary benefit plans.

In noting that California Choice has succeeded where previous and similarly structured state-run small-group exchanges failed, CHOICE Administrators Executive Vice President David Duker cautions that, “This time California cannot afford to get it wrong. The new exchange must work properly as millions of Californians will be depending on it. We want to advance into the conversation what we’ve learned from nearly 20 million member months of enrolling and administering coverage.”

Health insurance exchanges allow an individual or small business to compare the costs and benefits of various health plans and access available subsidies and tax credits. According to the health reform bill, small businesses with up to 100 employees can purchase health coverage for their employees in the state exchange. Beginning in 2017 states may allow businesses with more than 100 employees to purchase coverage in the exchange.

The new white paper entitled “Toward a Successful California Health Insurance Exchange” is available. In it the paper notes that California’s exchange will be entering a “mature health insurance distribution marketplace” and outlines how the state exchange could operate as both a standalone entity and as a collaborative partner with existing distribution and enrollment channels. By harnessing private exchange partners and tapping into the existing network of brokers and other insurance agents, Administrators President Ron Goldstein believes that California could achieve the goals set forth in the new health reform legislation “in the most efficient manner possible and without adding additional cost to the operations of the state exchanges.