Idaho insurance exchange officials don’t know if the 20,000 people signed up for coverage effective Jan. 1 hail from the ranks of the uninsured, or if they previously had coverage but switched to exchange policies because they’re now eligible for financial assistance.
Your Health Idaho board chairman Stephen Weeg and director Amy Dowd gave their first report to the Idaho Legislature on Jan. 21.
Afterward, Weeg and Dowd acknowledged nobody is collecting that information about those getting coverage. It’s a key question, because President Obama envisioned the online marketplaces as helping millions of uninsured people get policies.
“We’d love to have that data,” Weeg, a retired health care executive from Pocatello, told The Associated Press, adding one challenge will be avoiding intrusive questions. “When we develop our own data, we’ll have to figure out if there’s a way we can collect that information.”
So far, insurance agents have said many of those they’ve assisted in buying exchange coverage previously had policies. A smaller share came from the ranks of the uninsured, they said.
The Jan. 21 meeting in the Senate Commerce and Human Resources Committee was Weeg and Dowd’s first formal opportunity to face lawmakers during the 2014 session, to deliver their annual assessment of what’s been accomplished and what’s still to be done.
The 2013 session’s most disputed issue was whether Idaho should adopt a state-run exchange or default to the federal version that other, largely Republican-dominated states now have.
After 15 hours of debate, Gov. C.L. “Butch” Otter convinced lawmakers of the state exchange’s merits, arguing Idaho could run it more efficiently than the federal government. Currently, for instance, Idaho charges a 1.5 percent assessment on each policy premium, compared with the federal government’s 3.5 percent fee.
Dowd said Your Health Idaho will try to stick to that rate. But she called it premature to speculate on what the assessment rate will be come 2016, when Idaho’s exchange must be self-sustaining.
“We don’t know how much it will cost to run our call center,” she told lawmakers. “We don’t know how renewals will go in out years.”
She and Weeg credited the exchange’s 19-member volunteer board, as well as Your Health Idaho’s six-person paid staff and its squadron of private contractors, with getting the exchange running in a matter of months with nearly $70 million in federal grants.
“This has been an incredible journey, in an amazingly short period of time,” Weeg told the Senate panel. “We’ve kept Idaho in control. The federal government has not intervened.”
In addition to glitches with the federal enrollment website that plagued exchanges nationwide last year, Idaho’s exchange has suffered some homegrown setbacks.
In mid-October, Dowd awarded a no-bid contract worth up to $375,000 annually to a former board member. That drew fire from legislators who complained the inside deal was unfair and inappropriate.
The contract was canceled, but lawmakers Jan. 21 had lingering questions.
“I still find that a little hard to swallow, given the praise that’s been heaped upon the board,” Sen. Jim Guthrie, R-McCammon, told Dowd. “That does trouble me.”
Dowd acknowledged mistakes, not of the backroom-deal variety but the result of exchange officials racing to meet fast-approaching deadlines.
“We moved too quickly,” she told him. “We acknowledged it was a misstep.”
She said in the coming months, her main goal is to complete the state’s in-house enrollment system, to replace the federal HealthCare.gov site Idaho residents still must use. The exchange is nearing a decision on a contractor for that work, estimated to cost tens of millions.
“I’m committing to you a system with low long-term costs, a system that’s easy to use and works, and an operation that is right-sized to Idaho,” Dowd said.