Alaska’s federally run health insurance exchange is supposed to be ready to enroll participants on October 1st. But with that deadline less than six months away, insurance companies and the state’s Division of Insurance say they have little information on what the online insurance marketplace will look like.
Alaska’s Insurance Director, Bret Kolb, heard from a husband and wife last week. He says they wanted some basic information on the federal health insurance exchange:
“What is it going to look like? How does this play out? And unfortunately, we don’t know what a federally facilitated exchange is going to look like.”
Alaska, and 25 other states, decided not to develop insurance exchanges, which are required under the Affordable Care Act. When Governor Sean Parnell made that decision, he gave up millions of dollars in grants to establish the exchange and left the work to the federal government. The exchanges are online marketplaces that will allow consumers to shop for health care policies and determine if they qualify for subsidies to help pay for them. That may sound pretty simple, but there are a lot of complicated questions to work out. Questions Kolb says the federal government hasn’t been able to answer:
“The answers that we will get are: ‘Soon. We’ll get you an answer to that. We’ll get you guidance. We understand what the date is. We know the timeline but we don’t have an answer yet.’ Is what we’re getting from the federal government.”
The questions the state wants answers to are pretty simple: what will the exchange website look like? How much will consumers pay to use it? And when is the government going to start an advertising campaign to let people know about it? Insurers in the state have their own questions, including how they will connect electronically with the exchange. Jason Gootee is with ODS, the fourth largest insurer in Alaska. The company also offers health insurance in Oregon and Washington, where officials are establishing state run exchanges. And he says the difference between those states and Alaska is stark:
“We have weekly exchange implementation meetings and I sit in on all of those and there’s always a big flurry of activity for Oregon and Washington and when Alaska comes up, it’s basically we’re still waiting on what’s going to happen there. So we’re quite frankly on pins and needles because we want to be able to do this well.”
The state’s largest health insurer, Premera, is also eager for information about the federal exchange in Alaska. Jeff Davis is President of Premera in Alaska. He had hoped Alaska would set up its own exchange, so the state could design it to fit the needs of Alaskans. He says the company is committed to participating in the federal exchange. But Davis says so far, the federal government has provided very little information:
“We have tried and many, many others have tried and the answers range from, we’ll get back to you on that soon, we’ll have that for you the first of spring. Those sorts of answers are what we’re getting. It’s simply not available and I anticipate that means it’s not been worked out yet.”
The U.S Department of Health and Human Services declined to make someone available to interview for this story. A spokesperson says development of the exchange- or Marketplace- is underway and that “we are deeply committed to public participation in the building of the new Marketplaces.”
Stan Dorn is not surprised the federal government has been slow to provide information about the exchange. He’s a health policy expert with the non-partisan Urban Institute in Washington D.C. He says the politics surrounding the controversial health care law have hampered the process:
“Federal officials are very cautious and understandably so, they don’t want to make the slightest misstep, so they need to think very carefully, long and hard before they release any plans for what they want to do. It’s really a shame, it really takes what are usually slow processes and makes them even slower.”
Dorn expects the federal exchange to be up and running in Alaska on time. But he says it won’t have all the “bells and whistles” that will be available in states that are establishing their own exchanges:
“They’ll be able to get the basic job done, no question about that, but a lot of the more exciting features won’t be available until later years.”
One of those features that won’t be ready in time would let small companies give their employees a choice between several plan options when they use the exchange.
This story is part of a reporting partnership that includes APRN, NPR and Kaiser Health News.