Wash. Online Insurance Exchange Will Carry Coverage
By John Webster, The Spokesman-Review, Spokane, Wash. | |
McClatchy-Tribune Information Services |
Within those painted concrete slabs, an agency few have heard of is completely reinventing the way people and small businesses will get a precious and often unattainable commodity: health insurance.
Back in the 1960s, the building housed a
The only sign is printed on a piece of typing paper, taped to the door.
Inside these makeshift quarters, worn industrial carpet runs from cubicle to cubicle. The work spaces have rapidly filled with new employees: Intense software wizards. Middle-aged veterans of health insurance companies and government service agencies. Technical communication experts, hired away from such companies as
All of them work for a new player on the
At the moment, the exchange has about 60 employees. It is funded with
Several blocks away, girders rise skyward for a new, leased building the agency hopes to occupy sometime this summer.
The agency's task? Create and run a website where millions of
Which residents? Not
--Applicants for
--Middle-class workers who have no coverage or costly individual policies and need a better deal. Federal subsidies will provide that better deal.
--Small businesses, which often cannot find affordable coverage for their workers.
According to
For
For non-
The 10 essential benefits: ambulatory, emergency, hospitalization, maternity and newborn, mental and behavioral health and substance abuse, prescription drugs, rehabilitation, laboratory services, prevention and chronic disease, and pediatrics including oral and vision care.
Separately, the site will sell dental insurance plans as well.
The star-based ratings, officials say, will be based on hard data from medical claims and outcomes. Does a plan cover cholesterol checks? Does it provide annual eye and foot exams for diabetics? What about mental health; how well is that handled? "There's a lot of research going on right now" into the details of that rating system, Onizuka says.
Federal law calls for the site to be operational on
Tough federal rules will govern that coverage. The rules prohibit common insurance practices that make coverage unaffordable or unavailable, such as raising rates or canceling coverage when people get sick.
The site is already up and running, though it's unavailable to the public.
Onizuka, a specialist in health care technology, says
"We are sort of a pace car state," Onizuka said. "We wanted to build it the way that fits Washingtonians the best."
In states that don't build their own websites, residents will use a site being built by the federal government.
Security's an obvious priority. The Washington "Health Plan Finder," as the site will be known, faces a rigorous testing schedule in the coming months. Independent security and quality-assurance experts have been hired to scrutinize how well it works, Onizuka said.
The finder's application process must interact with federal data hubs to determine eligibility for benefits and subsidies.
How many will use the site?
In
This could make the pool of website users larger than expected. But until the system launches, all the state can do is make estimates in each of the three customer categories:
--
Currently,
-- Individuals. New federal subsidies will attract insurance buyers with incomes too high for expanded
-- Small-business employees. Today, some small employers cannot afford coverage for their workers. The Affordable Care Act offers subsidies, both to businesses and their employees, for getting on board. A small business, Marchand explains, will be able to pick a coverage level for its employees, decide how much the employer will contribute, and set itself up on the Health Plan Finder site. Then, the business's employees can go to the site, enter their information, determine their own eligibility for subsidies and purchase coverage.
Not everyone has Internet access, and not everyone has heard what the Affordable Care Act offers. For that reason, part of Marchand's job is to get the word out. The exchange will offer in-person assistance, in the form of trained "navigators," who will be deployed around the state to explain and interpret the system. For those who need personal assistance, lack computers or have questions while using the website, the exchange plans a telephone call center.
That call center will be based in
With the
Marchand knows the path will not be smooth. Technology comes with glitches. People can be balky. Change creates confusion.
"Somewhere down a dirt road in
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