Exchange meeting update…

Over the weekend, theCalifornia Health Benefit Exchange was the focus of a front page New York Times article (one where our director Anthony Wright got “Quote of the Day.”) The article featured an big photo of many allies and coalition members lining up to testify at the Exchange Board meetings–lines that were repeated at the Board meeting today in Sacramento.

First the Board heard reports from Exchange staff that have been making significant progress in implementation.  Highlights of these reports include:

CalHEERS The IT staff has been working together with staff at the Department of Health Care Services, the Managed Risk Medical Insurance Board, and consultants to review existing systems and work toward integration.  Advocates fear that inherent to IT decisions are policy decisions that will impact consumers greatly, and they urged that the Exchange better include stakeholders (other than health plans) in these conversations.
Naming and Branding Staff and consultants have conducted six focus groups with diverse groups of people to weigh in on the naming and branding of the Exchange.  As a result of this research, the list of potential names has been pared down to 4: Covered, CA; CaliHealth; Ursa; and Eureka.  Final selection of names and taglines will occur at the end of September, logo development and testing in October, and then legal review and logo approval in November. 
Outreach and Education Grants Recognizing that there are groups across the state that have existing trusted relationships with the Exchange’s target populations, the Exchange plans to provide grants to help complement broader efforts, and ensure culturally and linguistically appropriate outreach and education efforts.  The proposed plan could provide grants of $15,000, $100,000, and $250,000 to total $40 million ($20 million in 2013 and $20 million in 2014).  Many advocates expressed concern that this is an inadequate amount of money to cover the entirety of California, and that the $250,000 maximum amount is not enough for statewide work in a state the size of ours.  Board members Diana Dooley commented that resources were limited; Board member Bob Ross hope that the Board didn’t precluded the possibility of increasing the grant amounts at this time.
Federal Grants
In October, the board will decide whether to request another Level 1 Exchange planning grant or to request an Exchange Implementation (Level 2) grant, in time for the November 15th deadline for submission to the federal government.
Board Meeting Schedule for 2013
The staff put forth a proposed calendar for 2013 meetings with the hope that there will be no more multiple meeting months, and that they will continue to bring some of these meetings to other parts of the state.
Jan 17

Feb 21

Mar 21

April 24

May 23

Jun 20

Jul 25 – Tentative

Aug 22

Sept 19

Oct 24

Nov 21

Dec 19 – Tentative

The board then heard a proposal from staff for the Exchange’s Stakeholder Consultation Plan. Staff proposes continuing their use of webinar and the solicitation of written comments from stakeholders, and to convene 3 topic specific stakeholder advisory groups on plan management, marketing outreach and enrollment assistance, and SHOP, to begin in January 2013.  Advocates asked for specific opportunities to communicate with staff on the topics of Eligibility and Enrollment and IT.  While staff declined to create additional stakeholder groups on these topics, they committed to engaging stakeholders on these and other issues.. The board approved the staff’s proposal.
The board then discussed Consumer Assistance/Ombudsman options.  The staff brief presented several models for helping consumers when they encounter problems with coverage.  The recommended approach was partnering with regulatory entities and provide interim funding for this individual assistance, including to key community organizations. Under this option, the Exchange would partner with the DMHC and CDI to expand the scope of existing consumer assistance functions to assure that Exchange enrollees and eligible individuals have access to independent consumer assistance services.  Advocates agreed with Dr. Ross’ comments that the dollar amount allocated may not be enough.
Next, the board considered whether or not to contract out administrative support for the Small business Health Options Program (SHOP) Exchange.  The board discussed their concerns with having enough time to build a quality system that would be ready for consumers in time, and the drawbacks of using a vendor as well.  Advocates had mixed reactions to the staff’s recommendation to use a vendor, with concerns expressed related to whether vendors were broker entities that contract with some plans and not others, and whether they were suitable to be a consumer’s first contact with the Exchange.  The board approved the proposal unanimously.
The board then discussed Qualified Health Plan solicitation.  There are a number of discussions ongoing and many policy decisions that still need to be made prior to the solicitation that is scheduled to be released next month.  Exchange staff plans to release a draft of the solicitation on September 24th for stakeholder input. 
Lastly, the board heard an update on the screening and referral protocol related to the service center approved last meeting.  Staff presented three options for assessing whether an individual is eligible for the Exchange or needed to be handed off to the county for Medi-Cal, and how that hand-off or referral would happen.  Written comments are being accepted until next Tuesday using the feedback form on the Stakeholders page of the Exchange website.  
The next meeting of the Exchange will be on October 16, 2012 in Sacramento.


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