What’s the biggest challenge in implementing the Affordable Care Act’s insurance exchanges? It’s not making the digital connections work between agencies, exchanges and consumers,...

What’s the biggest challenge in implementing the Affordable Care Act’s insurance exchanges?

It’s not making the digital connections work between agencies, exchanges and consumers, though that’s very important, says Renard Murray, regional administrator of the Centers for Medicare and Medicaid Services’ Atlanta and Dallas regions.

The largest hurdle, he says, is education.

“Our biggest challenge is to get the word out to people,” Murray said in an interview late last week about the marketplaces, also known as insurance exchanges. They will begin enrollment just two months from now.

People will need to know the basics about the exchanges – the options, the rules, the benefits, and the important dates to keep in mind.

Polls show the information gap is huge. In an April tracking survey by the Kaiser Family Foundation, four in 10 Americans were unaware that the Affordable Care Act is still the law of the land and is being implemented.

The marketplace is one of two major ways the 2010 health reform law aims to extend coverage to millions of Americans. The other is through Medicaid expansion, which Georgia and many other states have rejected.

Still, more than 800,000 Georgians are expected to shop for coverage on the insurance exchange.

The feds plan to advertise the marketplace robustly in states that are having the federal government run their exchanges, Murray said. In the Southeast, only Kentucky is operating its own marketplace.

There will also be people on the ground and community organizations helping market the exchange process, in venues ranging from state fairs and conventions to, in metro Atlanta, the Decatur Book Festival, Murray said. Officials are also working with churches, schools, universities and even temporary employment agencies, which place many uninsured people in jobs.

A key target audience is the millennials – people age 30 and under – many of whom don’t have insurance.

Supporters of the ACA fear that many of these 20-somethings will not purchase coverage, choosing instead to pay a $95 penalty under the Affordable Care Act’s individual mandate. The whole purpose of the penalty was to encourage people to buy coverage, but many young people in good health may feel no need for insurance, and may just pay the $95 because it’s cheaper than getting a policy .

CMS wants these young adults to consider the advantages of having coverage.

“We’re looking at educating millennials that there is value to having health coverage,’’ Murray said. Breaking an arm could cost about $7,000 with no health coverage, he said. “That $7,000 could ruin your credit,’’ he added.

For people under 30, a catastrophic health plan is available on the exchanges at a lower premium, Murray noted. These higher-deductible plans will also provide first-dollar coverage for preventive health services and three annual primary care visits.

CMS officials have been meeting with millennials about their upcoming choices, Murray said.

Insurance “navigators,” meanwhile, will help consumers of any age wade through the confusion about the law. They will help educate people about their options, including what subsidies they can get, and help consumers enroll in a qualified health plan.

After they are named August 15, navigators will have a training course, which they must pass. “Certified application counselors” will also help connect consumers to the ACA’s coverage options. These volunteers will get extensive training as well, Murray said.

In addition, a national “Champions for Coverage” program will feature local organizations that will help inform people about the ACA. “There’s a tremendous amount of interest in this,’’ Murray said.

Then there’s Enroll America “Get Covered America” campaign, which is canvassing neighborhoods in a number of states to kick off several months of outreach efforts, Kaiser Health News reported Monday.

Enroll America, funded by health insurers, hospitals, philanthropies and others, has close ties to the Obama administration. It’s seeking to drive enrollment in the new marketplaces.

Health insurers also may promote the coverage in the exchanges, as they did when the Medicare prescription drug benefit debuted in 2006. Murray said he also expects insurance agents and brokers to be involved.

Enrollment can be done by paper, online at www.healthcare.gov or at the Health Insurance Marketplace call center at 1-800-318-2596.

What are the early questions from consumers? Murray said they include “When does this begin?” (Oct. 1) and “When does coverage start?” (As early as Jan. 1).


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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