The Illinois exchange wants to offer in-person consumer assistance in addition to federal navigators, as part of the partnership exchange. Covered California is pretty much covered financially until 2015 with federal grants. And as Wal-Mart expands into healthcare, HHS has rebranded exchanges as "marketplaces."
Illinois partnership HIX outlines consumer assistance models
One of seven states partnering with the federal government in building a health insurance exchange, Illinois is waiting for the Centers for Medicare & Medicaid Services (CMS) to approve its shared services blueprint.
Illinois is one state that'll be using a state-federal hybrid form of consumer assistance, with CMS running the navigator program and the Illinois exchange board running a program with in-person assisters, for local outreach and education.
CMS's Center for Consumer Information and Insurance Oversight published guidance on partnership exchanges in early January, largely encouraging states to take as much responsibility as they want, especially for states like Illinois that plan to transition to state control in the next few years.
CMS outlined the concept of in-person assisters as distinct from the navigators last July, in a state HIX grant funding announcement. Although the two programs would be governed by different funding requirements, Tricia Brooks, a professor at Georgetown's Health Policy Institute, thinks that they seem fairly similar, and noted that privacy and security standards will apply to both programs at the state and federal level.
While state and federal officials finalize plans for operating various functions of the exchange, health consumer groups have been advocates of creating public ombudsman roles for consumers and health plans.
Stephanie Altman, policy director at the Chicago-based group Health & Disability advocates, wrote recently that "Since Illinois has historic connections in the community and their understanding of the state-specific insurance, Medicaid and supplemental state health programs, the IPA program will be the primary contact for consumers and for insurance companies."
California gets $674 million in federal support
CMS recently awarded the California health insurance exchange Covered California $674 million, bringing the state's total federal grant budget to $900 million.
Covered California executive director Peter Lee, who has worked in several roles at CMS, told the Associated Press that the grants will cover a website, multi-lingual outreach campaign and staff call centers, and help carry the exchange through 2015.
Lee and others recently outlined Covered California's financial sustainability plans through 2017. Prohibited from accepting state funding by its charter, Covered California is funding itself through federal grants initially, and gradually transitioning to revenue from health plan premium fees of two to three percent.
There are about 7 million Californians ages 18-64 who are currently uninsured, and Covered California expects to help enroll at least 1 million of them. The exchange is planning a large marketing campaign, as part of a $900,000 PR contract with the global consultant Ogilvy.
Other commercial and nonprofit groups, like Enroll America, are supporting nationwide public awareness advertisements, with insurers and exchanges hoping for a range of demographics to help create sustainable risk pools.
Branding exchanges
In related insurance exchange news, a Wal-Mart VP told the Orlando Business Journal that the company was considering operating a health insurance exchange, as "one of the things we're looking at," as the retailer expands health-related businesses with pharmacies, Medicare Part D partnerships and vision centers.
Wal-Mart later told Bloomberg Businessweek it has no plans to enter insurance, and Businessweek noted that Wal-Mart would likely fare better in providing actual health services, considering the market rules for selling health plans.
Healthcare organizations, and many other industries, may be looking at Wal-Mart with a general sense of excitement or suspense, however; there've been partial-ideas floated, then retracted, for what would be new terrain in both the retail and medical industries.
NPR and Kaiser Health News reported in 2011 that Wal-Mart send out a call for potential business partners, to build a network offering medical services like diabetes management and blood-testing. Wal-Mart officials then too said they had no plans for a medical services network.
The federal government, meanwhile, is slightly revamping its branding of HIXs in communications, now primarily referring not exchanges as marketplaces.
Eagle-eyed Beltway media outlets like The Hill spotted the PR switch, and anti-ACA activists took it as an opportunity to criticize federal health policy. ACA advocates see the name change as a way to reach a broader consumer segment.
"It's not that exchanges are unpopular, but there also isn't broad awareness about what they are and what they will do for the people who will benefit from them across the country, so it makes sense to use a more descriptive name," one unnamed Democratic staffer told The Hill.