The Exchange Board Episode 4: Guest Starring Joel Ario

The California Health Benefits Exchange Board held their fourth meeting today.

The first substantive presentation made by Joel Ario, Director of Office of Health Insurance Exchanges at the Center for Consumer Information and Insurance Oversight (CCIIO) at the Center for Medicaid and State Operations. Ario outlined the vision for Health Insurance Exchanges from the federal perspective, touching on a variety of themes important to consumers. He said Exchanges should be competitive marketplaces, providing open, transparent, aggressive competition between insurers not based on risk selection but on cost and quality. He also touched on the importance of program integration and a high quality customer service experience for consumers including real-time eligibility determinations.

Ario also talked about the progress that the federal government has made doing their part in helping states get their Exchanges going, including planning and early intervention grants, and the development of guidance and regulations, including the highly anticipated Minimum Essential Benefits Standards which should be released in the fall.

His timeline for moving forward with Exchanges is as follows:

* Establishment grants
* IT: IT innovator states will move forward, the federal government will work on building of federal hub, and work on more plans for the federal fallback managed option
* HHS is close to completion on the first set of proposed rules, perhaps in the next few weeks.
* Essential benefits standard expected in the fall.

* Finalize two set of rules on Exchanges.
* Complete IT builds
* Certification of states’ Exchanges, Secretary of HHS must determine whether states have met the requirements for Exchanges.

* Insurers will come in for contracting, bidding process must begin.
* Enrollment process begins before Jan 1, 2014
* Information technology testing–Exchanges will need to be operational.

Ario encouraged the state to be “as ambitious as you can be” with Exchange grant proposals and supported Secretary Dooley’s insistence that California be a “pace car” for ACA implementation.

The bulk of the remaining meeting was spent discussing the Exchange planning grant application draft. Today’s discussion served as an opportunity for board members and stakeholders comment on the draft grant proposal. The Board will be taking action (to potentially approve the application) at the June 28th meeting and will be accepting written comments from stakeholders until then as well. You can view the grant overview here and the summary here and provide comments. The application proposes a $40 million budget, with 75 FTEs but with most of the resources going to consultants.

Consumer advocates provided a number of comments at the meeting. Broadly, there was a strong emphasis on a desire for additional resources to be allocated for consumer assistance, stakeholder participation, and outreach and public education. Additionally advocates petitioned the board to consider cultural and linguistic access for limited English proficient consumers both in the Exchange customer service experience and in the current planning and implementation process. Pat Powers, the Exchange’s Acting Administrative Officer reported that future meetings would take place in other parts of the state so that more stakeholders can participate, and that the Board would also hold stakeholder convenings throughout the state. Advocates asked that those meetings be translated to be accessible to all.

The Board was also given an update on the progress of the Executive recruitment process. A recruitment brochure has been created and the Board hopes to be interviewing Executive Director candidates by July and have an ED hired by August. The General Counsel will be hired next and they hope to have that individual in place by October. Staff encouraged the Board and stakeholders to contact the recruiter with leads or suggestions for suitable candidates.

The next meeting of the Exchange will be on July 28th, where they will take final action on the grant application.

Additionally, a stakeholder webinar will be held on Monday June 20 from 10:30am – noon. This will be another opportunity for the general public and a broader group of stakeholders to weigh in. We will provide more information as it becomes available.

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

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