Getting Down to Brass Tacks at the Exchange

A report from Beth Abbott, our director of Administrative Advocacy:

The California Health Benefit Exchange conducted its seventh meeting–and some would argue, its most substantive to date, on August 23, 2011 in Sacramento. They delayed the opening of the public session until 12:30 pm in order to provide sufficient time for the board to give full consideration to personnel and contracting matters in a closed session. The meeting lasted until almost 4:00 pm. The highlights were:


The Personnel Sub-committee, consisting of Diana Dooley and Paul Fearer, made a recommendation to the full board on the selection of an Executive Director. In closed session, the recommendation was unanimously adopted. They will now begin negotiations with the unnamed candidate whom they hope will result in that individual reporting as soon as possible to the Director position.

Diana Dooley, interim Exchange Board chair, was elected the permanent chair, now that all five board members had been appointed and were present for the vote.

The full board also announced the extension of the contract for the Interim Executive Director, Pat Powers, until December 31, 2011 for coordination and transition until the new ED reports.

They approved the extension of the recruiting contract to recruit and hire the remaining senior level exchange staff to replace (or augment) loaned staff, acting/assisting staff, and consultants.

They briefly discussed the Conflict of Interest policy. Consumer advocates asked that its adoption be postponed until they had a chance to more thoroughly review it. The board agreed but emphasized the urgency in its adoption.

Administrative & Federal Funding

The Exchange received their $39 M establishment level one grant that they requested.

Enrollment and Eligibility

Yolanda Richardson said they have begun their stakeholder process on enrollment and eligibility. They were particularly interested in the goals of providing value, efficiency, and transparency.

(Consumer advocates urged that the questions be expanded and appreciated that some meetings will be held in person in the future.)

Bill Obernesser gave an overview of their progress on IT and market research, most notably their market research questionnaire results from the industry on administrative and IT services. They received a good return (19 responses) and 7 companies were deemed to be most relevant in their answers. He stressed the staff and consultants were not making determinations, but were purely seeking information.

(Consumer advocates urged a re-examination of foundational principles underlying some of the questions and hoped that there would be an opportunity to examine those principles as this process went forward.)

Public comment, mostly from consumer advocates, but also health plans, associations, brokers/agents groups, and others urged examination of broader questions, “to get the fundamentals right” because the exchange would be enrolling millions of consumers, to be sure to integrate cultural and linguistic access to care, and not overly rely on technology when consumers need a variety of pathways to enroll.

Strategic Visioning

The board reflected their preferred language for the options for the Vision, Mission and Guiding Principles. It generated a lively discussion from several board members. This was an extension of the consideration of the models presented at the July meeting and some consensus emerged around the concepts of accessibility, innovation, transparency, efficiency, cost containment, improved health status, and world class customer service. The final language will be considered at the September meeting.

Federal Regulations

Lesley Cummings gave an overview of several of the federal regulations released by the federal government since the last Exchange meeting. She has asked other organizations for their early draft comments as she prepares the formal response from the exchange board. These regulations deal with the federal/state process for shared functions, multi-state plans, CO-OPs, reinsurance and risk adjustment, as well as the very lengthy exchange regulation itself. She welcomes comments from any interested party and urges that they be sent to her at

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