Problems weighing down Idaho’s insurance exchange were underscored the week of Oct. 21 when the Internet health care marketplace’s leaders predicted they now must enroll 5,000 people per month for coverage through March to meet 2014 goals.
In fact, even that may not be enough: According to internal documents, the federal government estimates Idaho is shooting for at least 40,000 people to buy federally subsidized insurance policies via exchanges that are a central part of President Barack Obama’s health care overhaul.
At 5,000 monthly, that would still leave Your Health Idaho 10,000 people short. So far, fewer than 100 have managed to buy a policy, board members have estimated, in part because the exchange is using the glitch-plagued federal data hub based in Washington, D.C., that’s hampered efforts to sign up and browse insurance plans.
Your Health Idaho officials are already preparing for the likelihood that enrollment could miss targets and they’ll be forced to raise the current 1.5 percent fee charged insurers on each policy sold, to make sure that the exchange is solvent come 2016, when it must be self-sufficient.
“At the rate we’re signing up people right now, we’re not going to be able to pay for lunch next year,” said Tom Shores, an insurance agent in Boise and exchange board member. “Regardless of all the conversations about whether we’re charging 1.5 percent, 1.5 percent of nothing is still nothing.”
Idaho’s exchange has been beset by home-grown distractions: Your Health Idaho executive director Amy Dowd on Oct. 16 awarded a no-bid contract worth up to $375,000 to former exchange board member Frank Chan for technology consulting, prompting complaints. Dowd, who earns $175,000 annually, saw her contracting powers trimmed last week, and the deal with Chan was canceled.
But other, more fundamental problems linger.
Even though the federally run exchange operating in 34 states has been modified to let people looking for insurance compare plans without first completing enrollment, that feature so far isn’t available in Idaho.
“I’ve got clients that are just super upset that they have to basically divulge almost everything in their entire life before they can get to the shop,” Shores said
Come Oct. 30, the exchange board is slated to meet on that issue.
“We’ve got to do something different. We can no longer wait for the federal platform to work wonderfully,” exchange chairman Stephen Weeg said.
Idaho insurers, meanwhile, complain they’ve been shut out of the process by Dowd and exchange staff, even though they have some suggestions for how to remedy the situation. What had been a behind-the-scenes point of friction emerged openly last week.
“It would seem to me, if we’re going to move forward here, we’re going to have to stop being in silos and start collaborating,” said Zelda Geyer-Sylvia, chief executive officer at Blue Cross of Idaho and an exchange board member, at Tuesday’s meeting. “I would think there are people on our carrier staff who would be helpful in this discussion.”
Dowd said she’s now looking to recruit the carriers — there are seven offering health and dental plans on Idaho’s exchange — to help clear roadblocks.
“That is part of the plan, to perform that outreach,” Dowd said.
One big problem: Even if the exchange does manage to post more information about the 146 individual Idaho health and dental policies on its Your Health Idaho website, such a move would still likely leave people without the capability of learning the level of federal tax subsidy they’ll qualify for, based on their annual income.
Idaho residents who earn between 100 percent and 400 percent of the federal poverty line will get help buying insurance. For a family of four, that range is income from $23,550 at 100 percent of the federal poverty level to $94,200, at 400 percent.
“It’s hard to shop if you don’t know the prices and you don’t know the subsidies,” said House Minority Leader John Rusche, D-Lewiston and another board member who suggested at least offering an example of subsidy levels on the Your Health Idaho web site.
Meanwhile, insurers have been fielding calls from frustrated customers rebuffed by the exchange. Blue Cross spokeswoman Karen Early says the insurer’s employees have been recording people’s contact information — with plans to get back in touch, once startup issues have finally been resolved.