Minnesota Test Drives Its Insurance Exchanges

Minnesotans are test driving their  prototype healthcare insurance exchange currently available on the state Commerce Department’s website. The state-based exchanges let consumers shop for healthcare coverage, compare various plans, and guide eligible residents through the process of applying for public subsidies.

Although individuals and small businesses won’t be able to use an exchange until January 2014, Minnesota has a deadline to get planning underway.  States must show they can operate an exchange by early 2013.  The federal government will operate the exchange in those states that fail to establish a viable model.  Some of the Minnesota prototypes are similar to online travel sites such as Expedia or Travelocity where consumers comparison shop.  The difference is that instead of comparing airfares and flight times, users compare the cost and coverage of different health plans.  The sites don’t allow the user to obtain specific information, such as the out-of-pocket costs for a knee replacement.  Some sites allow the user to compare plans based on a person’s age, gender and health habits, such as smoking.

According to Minnesota Exchange Director April Todd-Malmlov, the state wants feedback. “We’ll have a questionnaire tool that’s on there that will ask people what did you most like about this prototype, what could be improved about that prototype, and then give us a sense of who they are, who’s responding,  Are they a consumer, are they a provider, are they an insurer, so we can look at the responses and see how different groups think of the component pieces.”

Insurer Ceridian’s prototype website has an interactive simulation of shopping on its exchange, said Vice President Manny Munson-Regala.  “What you’ll have a chance to do is be in the role of a small employer, an employee.  You’ll get a sense of what the enrollment process will feel like, how you set up payments and confirm.”  Minnesota’s approach to building an exchange is unique, according to Munson-Regala.  Instead of asking companies to build exchanges from the ground up, Minnesota asked insurers to demonstrate particular components, such as the small employer or private individual access points.

Similar to filling out health insurance forms, additional information is needed to buy a policy.  Some of the prototypes require information about the individual or business before the user can even compare plans.  Public review of the prototypes is a great idea, said Geoff Bartsh of Medica, who said it’s important to assess whether consumers find the prototypes helpful or not.  The true heavy lifting will be making the prototypes work.  “I think the true test of them is going to be how they will actually make those functions happen within the state agencies, between state agencies, and federal agencies,” Bartsh said.

Writing in the Washington Post, Sarah Kliff says that “When Democrats decided to call the new insurance marketplaces created by the health reform law ‘exchanges,’ they didn’t exactly do themselves a favor.  The idea of a health insurance ‘exchange’ has never really caught on; it doesn’t conjure up anything specific in the minds of Americans.  Because of that, some health reform advocates have recommended forgoing the term altogether, instead calling the exchanges ‘marketplaces.’”

“The public gets a ‘marketplace’,” according to the Herdon Alliance, a pro-health reform strategy firm.  “They remain confused by an ‘exchange.’”  The standard definition of a health insurance exchange is a state-run website where individuals can buy coverage, although that probably means very little to many Americans.  The best way to understand the concept of a health insurance exchange is to see what one actually looks like.

Despite the prototypes’ test drive, Minnesota has not yet decided if the exchange will choose the health insurance plans that ultimately are offered, or if it will be open to all plans that meet certain requirements.

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