When enrollment in the health care law’s new insurance exchanges opens in October, the prospects for success will turn on a crucial element: people who actually understand health insurance coverage and can explain it in plain language to consumers.
Many Americans who will be signing up may never have had insurance in the past or aren’t fluent in English or might have trouble figuring out which plan will be best for their pocketbook and health condition. They probably will be using computers or paper application forms to enroll in health care coverage through the exchanges, which serve as marketplaces for the purchase of health insurance for individuals and small businesses.
California plans to deploy 21,000 people across the state to sign up consumers when enrollment in the health insurance exchange begins Oct. 1. The squads of trained, government-paid helpers will be armed with the know-how to untangle the complexities of insurance coverage.
In addition, the state is on track to open three call centers staffed by 1,200 customer service representatives who will explain the 2010 health care law and guide callers through their health insurance purchases. Those to be hired will be fluent in multiple languages, including Spanish, Cantonese and Vietnamese, according to state officials.
The idea of a health insurance exchange as laid out in President Barack Obama’s signature law seems straightforward: an online marketplace where people will shop for private health insurance, like buying an airline ticket or a hotel room. But making sure exchanges in every state are ready for business by the law’s deadline of 2014 has been anything but easy given the legal, technical and political questions surrounding them.
States had until Dec. 14 to tell the Obama administration whether they would be building their own exchanges. The answer was yes for 18 states and the District of Columbia. The remaining states, most led by Republican governors, will either have their exchanges run by the Department of Health and Human Services or take part in federal-state partnerships. One of the 18, Utah, is trying to gain permission to keep its current exchange even though it doesn’t conform to the federal law.
Maryland launched initial development of its health insurance exchange the day after the health care law was signed by President Barack Obama in March 2010. Now the state is one of the first to receive conditional approval for operating its new health care marketplace, much of the time under the guidance of a pediatrician-turned-bureaucrat, Joshua Sharfstein.
Sharfstein gave up a plum position in January 2011 as principal deputy commissioner of the Food and Drug Administration to return to his roots in Maryland, where the Harvard Medical School graduate had served as health commissioner in Baltimore.
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