Exchange Take 3

The California Health Benefits Exchange Board met for the third time today. The business of the day consisted only of 2 action items, approving the minutes of the last meeting and to make a decision about the Federal Exchange Establishment Grant. The Board decided to apply for Level 1 Grant by the end of June, which will begin to bring more preliminary planning dollars into the state.

The board also announced an additional meeting to be held on June 15, 2011. This meeting will be attended by CMS Director Cindy Mann, Joel Ario of HHS, and other representatives of the federal government. At that meeting, the Board will vote on the very few policy decisions that need to be made regarding that grant.

The remainder of the meeting was devoted to discussion on two areas that will be integral to the implementation of the Exchange. The Exchange website now has the full packet of materials.

First the Board explored Program Integration. Various state departments that will interface with the Exchange made presentations to the board about their current functions and operations with an eye to relevance to the operations of the Exchange. The Department of Insurance and the Department of Managed Health Care gave useful presentations about the functions of their departments and the work they are already planning to do to. Board Member Belshe commented that this represented a paradigm shift from a world where individual departments and programs were concerned only with their own programs, to one where everyone works together toward a shared goal of coverage for every individual.

Exchange Board, staff, and advocates all agreed that seamless transitions for consumers was of the utmost importance, that departments must work together to create a “no wrong door” approach where no matter where consumers first make contact, that they are screened and enrolled seamlessly in to the appropriate program, and that as changes occur that might impact their eligibility, it will not be the responsibility of individual consumers to figure out their coverage transition. Advocates pointed out that this is an opportunity to solidify collaboration between state agencies in order to present a consistent face to consumers and insurers, and put an end to discrepancies between agencies.

The board then discussed at Eligibility and Enrollment, first looking at lessons learned from eligibility and enrollment for public programs through the counties, and at MRMIB’s practices in enrolling consumers into AIM, Healthy Families, and the high risk pools. Terri Shaw gave a presentation about the national project to design a 21st Century User Experience, which is working on elements that can be included in Exchange web portals across the country.

Advocates chimed in to emphasize the importance of making every door the right door to enter into coverage, taking extra measures to do outreach and education, to ensure cultural and linguistic appropriateness, to bring coverage to consumers rather than forcing them to seek it out, to address the needs of small businesses, and to collect the appropriate data to enable evaluation of what is working with what populations.

As always, we attempted to livetweet the discussion, at

Health Access California promotes quality, affordable health care for all Californians.

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