Even as the deadline for state declarations and blueprints was extended again this week and many states race to get their exchange plans prepared in time, California took an important step towards establishing its state-based health insurance exchange, Covered California. The state’s exchange board formally approved their exchange blueprint and made plans to submit it to the Department of Health and Human Services (HHS) today.
Most states are not as far along as California but more about that in a minute. First, a quick review of the new exchange deadlines:
- States planning to have a state-based exchange must submit their blueprint to HHS by December 14, 2012. The blueprint has two components: a declaration letter from the governor outlining the type of exchange the state plans to have and an exchange application that describes how the exchange meets or will meet all applicable legal and operational requirements by October 1, 2013.
- States that do not submit a blueprint for a state exchange by December 14, 2012, have until February 15, 2013, to submit a blueprint for a partnership exchange, otherwise HHS will plan to operate a federally facilitated exchange in the state.
Now, back to California. The state submitted its declaration letter months ago, on July 10, 2012. In its blueprint approved this week, the state described its approach for:
- Developing stakeholder and tribal consultation policies;
- Launching a marketing, outreach, and public education program;
- Developing enrollment assistance functions including a call center, a consumer-friendly website, a statewide assisters program, and an insurance agent payment policy; and
- Implementing the relevant business rules associated with eligibility, enrollment, and retention.
Covered California is also proposing to create three different programs to help educate consumers about the new exchange and get consumers enrolled in coverage.
1) A community-based outreach program will provide approximately $43 million in grants between 2013 and 2014 for grassroots public education and community outreach activities. The state plans to begin accepting applications for cycle 1 of this grant program beginning December 21, 2012.
2) An in-person assistance (IPA) program will provide enrollment assistance support to consumers. The state proposes to pay trained assisters $58 for each application that results in a successful enrollment in a plan offered through the exchange. This program will begin no later than October 2013.
3) A navigator program will provide grants to organizations that will assist consumers and small employers with the enrollment process. These entities will conduct public education activities to raise awareness about Covered California, help people apply for and enroll in health plans offered through the exchange, and provide referrals for complaints. The navigator program will begin no later than January 2014.
The exchange board also announced plans to seek a $706 million level 2 federal exchange establishment grant to cover its expenses through the end of 2014.
We will be watching closely as other states submit their declarations and blueprints, and you can keep track of the latest on state decisions on our State Profile pages.