Here’s our report, from Judi Hilman, our new Director of Policy Research and Communications, on the five-hour Covered California Board meeting on Thursday, August 21
Though not without controversy and heated repartee, the first full Board meeting at their new digs across from the Cal Expo summarized both how far California’s exchange has come in meeting its initial goals and how much farther it has to go to reach consumers with enrollment barriers.
Speaking directly to the latter, Black Caucus Assembly Members Cheryl Brown and Steven Bradford challenged Covered CA for failing to engage credible marketing strategies, indicating their disappointment with enrollment results for African Americans. They specifically asked Covered CA to contract with firms with a proven track record in targeting African Americans and to dedicate sufficient resources to these contracts. Board members and public comments alike affirmed the need to address these concerns.
Resolving Eligibility Inconsistencies (Executive Director’s Report)
Covered California Executive Director Peter Lee tackled an issue of grave concern to advocates: resolving eligibility inconsistencies (when the exchange cannot verify income or immigration status usually because the enrollees do not allow their personal data to be ‘pinged’ through the federal data hub). In particular, over 100,000 Californians–most if not all are likely citizens–need to show documentation of their citizenship or will be discontinued from coverage. To minimize disruption to the renewal process, Covered CA is taking a high-touch, multi-channel approach and reaching out to impacted consumers soon after Labor Day.
Public comments highlighted the need for a broad marketing strategy with nuanced messaging for immigrant communities, particularly those with fears of deportation. Several others asked for translation of notices into the 13 threshold languages (languages spoken at a high proportional rate by region) per state law.
Board Advisory Committees: Restructuring and Network Oversight
Board members and stakeholders were generally supportive of a plan to consolidate various outreach committees, including the Marketing, Outreach, and Enrollment Advisory Committee, now chaired by recently-nominated Health Access Executive Director Anthony Wright, while still leveraging input from the community-focused subcommittees of specific sub-populations, including African-American and Latino groups.
Speaking for Health Access, Beth Capell asked that two recurring topics figure prominently into the Plan Management Advisory Committee’s benefit design discussion: network adequacy (assigned to the September meeting) and alternative benefit designs (grandfathered plans that do not meet ACA or California’s more ambitious ‘active purchasing’ requirements), given that the latter make up a diminishing sliver of market share.
The Return of Proposition 45
Executive Director Lee provided the staff’s long-promised analysis of the potentially disruptive impacts of Prop 45 on Covered California’s active purchasing goals, open enrollment timeframes, marketplace choices, and subsidies for consumers. The materials feature correspondence, including from the Insurance Commissioner, who is supportive of Prop 45, making declarations about his intentions in implementation to resolve some of the issues addressed. Two board members–Schwarzenegger appointees Susan Kennedy and Kim Belshe–argued that the Board should take a position on the ballot measure, while Paul Fearer, Secretary Dooley, and Executive Director wondered, regardless of their personal opinion on the subject, if that wasn’t the best for Covered California’s trust and brand–and noting how much time on this issue was distracting from preparation for the next open enrollment. The discussion indicated that the September meeting will have a placeholder item for potential action.
New Regulations: Proposal to let Insurance Agents off the Hook?
Covered California adopted new rules on agents and brokers, and a range of other subjects. Not enough notice was given to properly debate the details, like the proposal to relax training and contractual requirements for insurance agents and brokers, said Beth Capell on behalf of Health Access. The Exchange offered to work with advocates and potentially make adjustments. One question raised by advocates including us and Consumers Union: Does it make sense to change the agent’s license agreement period to five years from one year in such a dynamic marketplace?
Other Discussions Worth Noting
Looking ahead to open enrollment for year 2, advocates highlighted the need to minimize churning and ease the transition between Medi-CAL and Covered CA, especially for mixed coverage families and to help enrollees choose the right plan, i.e. one that maximizes the subsidies and benefits available. The Board got presentations from Kaiser Family Foundation—these are worth a look, providing reasons for Covered California’s success in year one and valuable lessons for outreach and enrollment in year two. In general they suggest a focus on market segmentation and personal, ‘high-touch’ outreach strategies.
See all meeting materials here: http://board.coveredca.com/meetings/