Note: An expanded version of this post was originally published by Kansas Health Institute on July 14, 2011. Anna Lambertson, Executive Director of the Kansas Health Consumer Coalition and Sheldon Weisgrau, Director of the Health Reform Resource Project co-authored the original op-ed.
Kansas consumers who try to purchase health insurance face many challenges. The number of plans and options may overwhelm them, or they may be unable to afford the plans they find in the private market.
The Kansas health insurance exchange could make buying insurance easier for consumers.
The exchange is an online, competitive health insurance marketplace. This marketplace is a key part of the Affordable Care Act and must be up and running by 2014. Through the exchange, Kansas consumers will more easily navigate the process of purchasing health insurance. The exchange will provide consumers with easy to understand information about insurance plans and allow them to make apples-to-apples comparisons of policies. Kansas consumers meeting the income requirements will qualify for subsidies to help them afford coverage.
Kansas has recently seen a lot of activity related to the health insurance exchange.
In February, Kansas was one of 7 states awarded an early innovator grant by the U.S. Department of Health and Human Services (HHS) to lead the way in developing IT infrastructure for the exchange. The Kansas Insurance Department has created workgroups composed of stakeholders from across the state to develop recommendations for how the exchange will be governed and operated. And earlier this month, HHS released proposed regulations to guide states in creating exchanges.
But for the Kansas exchange to work for those who will use it—individual consumers and small employers—we must develop the exchange in keeping with their interests.
The Kansas Health Consumer Coalition has brought together a group of consumers and organizations representing the broader advocacy community. Together, this group has developed a set of consumer-focused principles to guide the creation of a health insurance exchange in Kansas.
These principles include:
Consumers must have an active voice in designing and overseeing the marketplace. As its primary users, individuals and small businesses know best the features and functions that will serve them.
The marketplace must operate openly and with transparency. Open meetings, public reporting on information, process and key decisions, and sharing of data and analyses are necessary for a fair and equitable exchange.
The marketplace should be operated by a non-profit entity outside of government, but in collaboration with relevant state agencies. A majority of the governing board should consist of users of the exchange and their representatives, including individuals and small businesses.
Finally, the marketplace must be fair. Younger, healthier consumers should not be steered to policies outside the exchange, leaving sicker, higher cost individuals in the exchange. This phenomenon, known as “adverse selection,” poses a significant threat to the success of any health insurance marketplace. The rules governing the market, both inside and outside the exchange, must therefore be consistent.
We have a unique opportunity to design a health insurance marketplace that offers quality and value to Kansans and simplifies the purchase of health insurance. The principles embodied in “Making the Kansas Health Insurance Exchange Work for Consumers” are key to this process.