October 1 was the deadline for states to submit their essential health benefit plans to the Department of Health and Human Services -- a "soft deadline," the agency has said.
23 states, DC meet EHB deadline
October 1 was the deadline for states to submit their essential health benefit plans to the Department of Health and Human Services -- a "soft deadline," the agency has said. 23 states and Washington D.C. submitted plans that'll be their baseline all for health insurance sold in 2014, in and out of their health insurance exchanges.
Notably missing the deadline, as JDSupra noted, were Minnesota and Nevada, which have both pursued HIX creation with some enthusiasm, although not a lot of regulatory detail.
No word from HHS on how or when the "fallback" federal essential benefits might be imposed on recalcitrant states. November 16 is the deadline for HIX blueprints.
HIX tech contracts
Following federal dollars leaving the Beltway, the Washington Post noted a few IT and consulting contracts for state HIX building.
Reston, Va.-based Maximus got started this summer building Minnesota's HIX for $41 million, on a two year deal. Dublin-based Accenture landed the $359 million contract to create and install California's HIX and to operate it for about three years after it's live.
Another Reston-based company called hCentive, founded in 2009, is doing HIX work for Colorado, Massachusetts and New York and is also aiming to help build the software for insurers to be able to operate in the exchange.
"In the near-term, the addressable market at a state level is limited," Maximus told the Post. "[T]hat market will grow over time."
Portrait of the newly insured
A report from Pricewaterhouse Cooper's Health Research Institute offers a demographic portrait of the soon to be newly insured, as PhysBizTech wrote.
There's going to be about 30 million new health consumers in 2014, the report forecasts, with about 32 percent gaining coverage through Medicaid, 45 percent through exchanges and about 25 percent through expanded employer coverage.
The median age of the newly insured is 33 and 88 percent say they're healthy today. Some 85 percent don't hold a college degree, less than half are employed full time and about 30 percent speak English as a second language. The group's median income is around 166 percent of the federal poverty level, about $38,000 for a family of four. And with fluctuating income, PwC expects some number of the newly insured to slide in and out of eligibility for Medicaid and HIX subsidies.
Also, PwC estimates that the 27 states that haven't decided to create HIXs will probably take the federal model. That's more than expected, and details of potential federal models aren't clear. As the New York Times wrote in August, much of the federal HIX planning has been done in Washington, and rather opaquely, and the exchanages are likely to be customized for states, with the help of a lot of contractors.
Promoting the HIX
The HHS's Centers for Medicare and Medicaid Services has hired the New York-based PR firm Weber Shandwick to market what will eventually become federally-facilitated HIXs, with a contract worth $3.1 million.
With some 3 million people hoped to enroll in its HIX in 2014, California is paying Ogilvy Public Relations Worldwide some $900,000 to market an exchange that's been floating around names like "Healthifornia" and "Avocado."
The Ogilvy plan, as the New York Times wrote, "includes ideas for reaching an uninsured population that speaks dozens of languages and is scattered through 11 media markets: advertising on coffee cup sleeves at community colleges to reach adult students, for example, and at professional soccer matches to reach young Hispanic men."
With private HIXs vying for a lot of the same consumers as the state-based HIXs, marketing and outreach may be a large factor in their success. Cover Oregon, the state-based HIX, has a simple website with an insurance calculator and stories of Oregonians, like Jim Hinsvark, an organic berry farmer who had a now cured pre-existing condition that left him without insurance when his COBRA policy expired some years ago.