Being in limbo is never a good feeling – it’s in our nature to make decisions, feel comfortable, and find solid ground. So many state leaders may be feeling uncertainty and hesitancy now, as they weigh the pressure to move forward with building a health insurance exchange with the knowledge that the Supreme Court will soon weigh in on the future of the regulations. As my peers have pointed out recently, states are taking different approaches to handling being in limbo. Some are moving forward with confidence, some are testing the waters, and others are doing nothing – determined to wait and see.
One thing is certain, however – there is an opportunity for states to examine how to best use technology and solutions to serve people, regardless of how the regulations play out. As the researchers at Urban Institute point out in this New York Times article by Robert Pear, the states currently making the least progress toward an exchange are actually the ones that could benefit the most from an Exchange, because they have large numbers of uninsured residents.
States can move forward now with the following considerations, which will be helpful in either the event that the health insurance exchange mandate is upheld and they are asked to move forward, or in the event that they have more flexibility, but still need to use technology to best serve their citizens.
Proceed with the Center for Consumer Information and Insurance Oversight (CCIIO) funded planning
Begin with the learning that would be useable whether or not the mandate is upheld, including:
- Efficiencies that will impact the Small Business Health Options (SHOP) program – the small business group component of Exchange
- Public sector eligibility system and process improvements
- Develop an awareness and education approach to outreach to those who will be eligible to buy insurance through the Exchange
So while states might be tempted to be in limbo for at least the near future waiting for the final word on health insurance exchanges, they don’t need to sit idly by. There are actions policy makers can take now to prepare that will put them in a great position if they need to move forward with an exchange as it is currently required, but will also be of benefit and not go to waste if the Supreme Court reverses this part of reform.
Kevin Walsh is vice president of the Healthcare Eligibility and Insurance Exchange Services of Xerox. This article brought to you by Xerox Corporation: http://xrx.sm/BF4.
Good and practical advice, Kevin.
Not only are the states who are failing to move forward those with the highest rates of the uninsured – they are playing right into the hands of the federal government, as I describe in http://www.realclearmarkets.com/articles/2012/03/28/watchful_waiting_obamacares_day_in_court_99589.html
When a state engages in stonewalling on building an HIX, this complex task defaults to the feds. If a state waits long enough, it will be too late to create its own HIX in time to meet the program’s start date; small businesses and individuals living in the state will then purchase their mandated (or not mandated) coverage through the federal HIX – exactly what a red state wants least to happen.
By choosing to watch and wait, these states are playing right into the hands of the Obama Administration. In their resentment of federal power, their foot-dragging will help, paradoxically, to galvanize that power.