What a state insurance exchange might look like:
For more than a year, Minnesotans have heard about health insurance exchanges. They are a cornerstone of President Barack Obama’s health care overhaul and, in Minnesota, at the heart of a partisan brawl between Gov. Mark Dayton and some Republican leaders. Until now, an insurance exchange in Minnesota has been just an abstract idea. But now,prototypes for public review are available on the state Commerce Department’s website. The state-based exchanges will allow consumers to shop for health coverage, compare health plans, and guide eligible residents through the process of applying for public subsidies.
Go here to look at the sample sites.
Health Insurance Exchange Section Module Testing
Welcome to the public testing and evaluation of sample section modules of the Minnesota-Made Health Insurance Exchange. As we work to develop the core features of the Exchange, we invite your suggestions and ideas. Our goal is to design a strong interactive platform that you will find easy to use and that gives the information you want.
The sample modules below are a series of interactive websites designed to simulate what an Exchange might look like. They encompass all the basic functions that the Health Insurance Exchange will need to perform: eligibility determination; individual enrollment; small employer eligibility and enrollment; health benefit plan options and costs; navigator/agent/broker listing; health care provider information; premium aggregation and payment; and account administration. You may view whichever module simulations you choose..
I liked the prototype offered by Deloitte Consulting the best because it’s the simplest to enter and I don’t have to watch video.
Update: in my state, our GOP insurance director is refusing to do her job and make plans for a state exchange.
Supporters of the federal Affordable Care Act are getting antsy over Ohio’s stalled action on implementing the law, which could land it with a federally run insurance exchange.
Minority Democrats in the state House of Representatives sent a memo last week asking Health and Aging Chairman Rep. Lynn Wachtmann to schedule Lt. Gov. Mary Taylor, also state insurance director, to testify on the progress in planning a state-run exchange – essentially an online comparison marketplace for individuals and small employers to buy health coverage.
I used Deloitte. Are you supposed to end up with a list of plans? I get a framework for a page but no plans listed, which I guess makes sense.
One thing re Deloitte: I couldn’t find a way to completely clear the form. I listed two people, then tried to delete the second, but the radio buttons re smoking wouldn’t clear.
Totally agree. It engenders confidence to feel like you can just start plugging in your variables to search for a plan rather than feeling like you have to take a master’s course on the subject first.
And I didn’t view it using IE7– a disclaimer that, by the way, initially undermined my confidence.
Outsourcing the creation of the exchanges to states run by poltroons will, I’m afraid, prove to be among the least forward-thinking pieces of the ACA.
Why worry? With the GOP running the show right now in Ohio, I’d rather have the Feds create the exchange anyway.
That’s going to drive people crazy. I (have) used the federal site like this: someone who doesn’t have an internet connection comes in for something else, and in the course of that visit asks about health insurance.
If you’re entering someones info, you need to allow for lots and lots and changes.
I’ve gotten fairly good at using the federal site.
You’re right, it just bothers me that she won’t do the job she’s paid to do. Her job isn’t to run around the state and make stuff up about the health care law. I’m not paying her to do that. Is there anything they don’t turn into a partisan political campaign?
Just shut up and do the work, or quit.
I know that, at some point, IDEO is or was involved with helping the Feds create health insurance exchanges. That, in itself, is a good sign. Though I don’t know exactly who’s working on what and with whom. Or exactly where in the process these kinds of design firms are getting involved. But it’s good to see some heavy hitters working on these kinds of problems rather than building a better toothbrush (not to undervalue toothbrushes, but really, I think our national dental hygiene infrastructure is currently in pretty decent shape…relatively speaking).
The Other Chuck
If the state doesn’t have any exchanges running by a deadline, then they default to a federal system, right? I guess the Ohio state government is all for single-payer.
I hope the Feds will take the best of the state designed exchanges and use that as a template for the states that are digging in their heels and refusing to get going. The discussions in CA are moving right along, with an emphasis on making it as user friendly as possible with what they call “no wrong door” format. This means that people will be able to flow easily from the private insurance to the MediCal sign up or back the other way, depending on what they qualify for. Hopefully the days of having a different form and a different office for every program (and thus having many people who would otherwise qualify for services fall through the cracks) will be over.
I suspect that some of the sample sites aren’t going to get very much useful feedback, given the usability barriers to casual browsing. Getinsured, for example, wants you to register with their site before they’ll show you anything. Curam starts with three questions, with defaults assuming that you’re not a U.S. citizen, you’re not a state resident, and you not in jail. (At least the last is probably the most frequent answer.) I could go on, but basically it involves more work than it should to see how the exchange would function, and that means the feedback they’ll be getting won’t be representative of their target population.
But that itself is feedback, right? They should have anticipated that, and if they didn’t, maybe they shouldn’t do the design.
It’s interesting to see what the designers think is important, on the first page.
I myself, for example, don’t need a giant welcome sign. It gives me the feeling I’m going to be wandering around in there for hours, that I’m embarking on a journey, which is exactly the opposite of what I want to feel when I’m (crankily) looking for health insurance. No trips. I don’t want to go.
We’ve had this kind on thing in NYS and NYC for several years, and it doesn’t do anything to make health care affordable.
The problem with affording health care isn’t that it’s hard to shop around and find the “right” plan. It’s that the plans are way over-priced and the doughnut hole — the people above state-assistance and below being able to write $1500 checks every month — is simply cut loose.
Exchanges are like a shopping guide at a terrible mall. No matter how good the guide, the mall will still stink.
Mary Taylor is getting paid about $156,000 per year in her combined role as Lieutenant Governor and inactive Insurance Commissioner.
More information on exchanges at the link. They will be setting rules for minimum coverage. They will also offer tax credits to subsidize premiums for those who qualify (these go way up into middle-class incomes), and increasing Medicaid coverage to cover millions more people, including childless adults, for the first time.
It’s a damn good thing we had a third party candidate for gov in MN in ’10, or we might well have elected a wingnut who makes Kasich or Walker look like Floyd B. Olson.
Why do Republicans hate the Free Market so much?
San, we get a lot of questions on the pre-existing conditions plan from middle aged people who are unemployed.
For months, she had a phone number up at the link from the federal site.
Just a phone number.
She’s fucking TRYING to hurt these people, and they’re paying her.
West of the Cascades
Comrade Mary — I used Deloitte, too – plugged in what looks like a residential part of Minneapolis that’s similar to my home in Portland – “Hennepin County” and “55402” on the first page — it did give me a list of 200 plans, but I had to scroll down on the “results” page to see them. It was a little confusing that you had to scroll down to see the plans.
When I clicked on the left side to modify the results, I clicked on “1000 to 2500 deductible” and “monthly cost 200-400” it came back with five plans. I started to cry because (if these are really realistic, and don’t have exclusions or kick you into a different price range if you have a pre-existing condition) this is exactly what I have always dreamed of health insurance shopping being like.
I lost my job a year ago and have done OK trying self-employment, but my health coverage is a conversion plan from a COBRA plan from a different employer in a different state from five years ago (my most recent employer did not offer health insurance). If these are in any way representative of how someone will be able to shop for health insurance, and actually buy the plans listed without any “gotcha” by health insurers, it is as good a thing as I can imagine federal legislation in this century doing.
I want to snark and say something about “death panels,” but it seems like if people would actually look at what the results of the ACA are (instead of listening to the lies from the right), it could be a wake-up moment for people to realize they’re being lied to. I don’t know how you message it simply, though.
Jim, I really don’t know where to start with your complaint.
The whole point of the ACA was to address the “hole” you’re talking about with federal subsidies.
It isn’t about the website. Minnesota is putting a lot of care into theirs, but that is not actually the point of the ACA, to set up websites.
The point is to cover people who are between 133 and 400% of poverty level.
That’s how it’s different than the NY site. Add billions of dollars in subsidies and 400 pages of regulatory structure.
Here’s a quick way of explaining it:
Everyone gets access to the same health insurance as their congressperson. Folks that can’t afford it get subsidized.
This is explicitly in the law; congresspeople have to sign up for the exchange. The Republicans thought the Democrats would balk at it; I believe Franken and Sanders were amongst the people that thanked the Republicans for their awesome idea and got it put in the bill.
I had the same feeling. I don’t want to read a message from the insurance company’s CEO, or spend five minutes watching a video of a happy persona (an artificial user produced by interaction designers) wandering through the interface, clicking buttons. I want them to tell me what’s important, if I don’t know already.
Between the partisan brawl in MN, and the partisan refusal to do work required, and all the other states out there messing this thing up, it’s as if the GOP doesn’t actually believe that markets work.
More precisely, markets don’t work when there is transparent, accessible information.
Because of course markets yeild much higher profits to market-makers if the process is murky, comparison shopping is hard, and barriers to entry abound.
Huh. “Free” markets. How do they work?