The federal-run health care exchange, which launched on Oct. 1, has been largely underutilized in the 36 states that have adopted it. But Connecticut and a few of the nation’s other 14 state-run systems have fared much better. Of the 13,128 people who have signed up for coverage in Connecticut, 56 percent — 7,572 people — are enrolled in private insurance plans. The other 5,556 have signed up for Medicaid.
While the Affordable Care Act continues to struggle with enrollment numbers, Connecticut has operated a relatively problem-free exchange through its provider Access Health CT. Starting in October, these exchanges, including Connecticut’s Access Health, began offering Medicaid programs and selling private insurance plans with discounted premiums subsidized by the federal government. The state has garnered 100 percent reimbursement for the exchange’s operating costs through the federal government. As of last Thursday, 13,128 people had signed up for health coverage through Access Health, but the small-business portion of the exchange’s activity has been smaller than expected, according to Access Health officials.
The Affordable Care Act has provided federal grants for states to create healthcare exchanges: organizations created specifically to facilitate the sale of health insurance to state residents.
Lieutenant Governor Nancy Wyman praised Access Health CEO Kevin Counihan and his team for their efforts in creating an accessible system for the 344,000 uninsured Connecticut residents.
“This cost us a lot of money, because hundreds of thousands of residents were getting their healthcare through the emergency room,” Wyman said.
Access Health developed an easily accessible website available in 70 languages that allows users to compare plans offered from the three participating insurance companies — Anthem Blue Cross and Blue Shield of Connecticut, ConnectiCare, and HealthyCT, a nonprofit organization. Wyman noted that a four-person family that makes $60,000 a year right now is paying $600 a month for health care, but, using Access Health, that family would only pay $100 a month because by comparing plans, families can make more informed decisions.
To ensure the state’s exchange was ready to launch Oct. 1, Counihan and his team conducted a series of tests early on — including system integration in July, user acceptance testing in August and testing a call center in September to answer concerns from customers. Counihan believes there are three reasons why the exchange has been reasonably effective thus far: a stable website in comparison with healthcare.gov, customer ease on the website and in the retail stores and outsourcing as many tasks as possible.
“We knew that there could be some glitches but we were fortunate. Because of the work the exchange staff did, it turned out to be a great start for us,” Wyman said. “Right now, the companies that we have are giving quality insurance.”
Access Health has employed 300 navigated assistors who speak 100 different languages to help customers navigate the online enrollment process, as well as independent brokers who routinely come to the retail stores to help customers pinpoint distinctions between insurance plans, Wyman said.
She added that there are two retail stores, one in New Britain and another at 55 Church St. in downtown New Haven, in which state residents can explore their options and sign up for coverage with personal assistance. It is the only state in the country to offer such storefronts.
“We believe that the ACA largely promotes constructive disruption — it basically says that the status quo needs to be changed and incentivizes states to be creative,” Counihan said. “We believe [the stores] are very much aligned with this goal.”
The New Haven store location’s manager Mike Dunn believes that the stores serve as a great way to address the population of people not comfortable with computers or sharing their social security number over the phone.
Counihan said that New Britain and New Haven were selected because these two areas have the highest concentration of uninsured residents and help cover the northern and southern sections of the state.
“This was meant to be an experiment — it’s an idea that we stole from the Apple Store,” Counihan said. “It’s been successful and we’re planning on expanding [the number of stores] but we need to make sure the criteria for success is met.” In a year or two, Wyman expects that more insurance companies will be added to the exchange.
Connecticut has also rolled out enrollment fairs that cover areas that do not have Access Health stores within them — they set up a mobile office in these locations for a day in a library or town hall, Dunn said, adding that Access Health brings staff members in and provides another opportunity for state residents to participate in the enrollment process.
Connecticut is the only state in which more people have applied for private coverage than Medicaid through the health insurance exchange, Wyman said. James Wadleigh, Access Health’s CIO, noted that the state began expanding Medicaid in 2010, shortly after the health law passed, which helps explain the comparatively low volume of Medicaid applicants in Connecticut.
The Connecticut exchange has a customer satisfaction level of 96.5 percent, according to a survey of users in October, with more than 82 percent of enrollees either “extremely likely” or “very likely” to recommend the exchange to a colleague or friend.