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Eye On Boise

For Idaho uninsured, exchange starts Tuesday

In this Friday Sept. 20, 2013 photo, Amy Dowd, executive director of the Idaho Insurance Exchange, discusses the insurance packages and other details of the online marketplace in Boise, Idaho. Dowd has been working for months to get Idaho's state-run exchange ready for the Oct. 1 launch date. (AP / Todd Dvorak)
In this Friday Sept. 20, 2013 photo, Amy Dowd, executive director of the Idaho Insurance Exchange, discusses the insurance packages and other details of the online marketplace in Boise, Idaho. Dowd has been working for months to get Idaho's state-run exchange ready for the Oct. 1 launch date. (AP / Todd Dvorak)

Idaho’s state health insurance exchange opens Tuesday, allowing about 200,000 uninsured Idahoans to begin enrolling in health insurance plans; the coverage starts Jan. 1. Amy  Dowd, a health care consultant hired in April to run Idaho’s exchange, told the AP’s John Miller, "We don't have a set target we're expecting for enrollment. Our goals for our open enrollment period are to educate, get the word out that this is available." Click below for Miller’s full report on the exchange startup, including a by-the-numbers roundup of costs, salaries, carriers, where to call and more.

Meanwhile, S-R reporter John Webster has a report here on the health care reform law changes and what they mean for you, whether you’re on Medicare or Medicaid, insured through your employer, have individual coverage now or are uninsured.

For Idaho uninsured, exchange starts Tuesday
By JOHN MILLER, Associated Press

BOISE, Idaho (AP) — Idaho's $70 million insurance exchange starts Tuesday, allowing about 200,000 people to enroll via its Internet site for federally subsidized insurance. That's a key component of President Barack Obama's health overhaul.

Don't expect an immediate marketing blitz, however: Television, radio, and newspaper ads, budgeted at $3.5 million, won't roll until late October, later than originally planned.

A skeptical Idaho Legislature approved the exchange in March, leaving too little time to get everything ready for this week's rollout.

Even now, exchange director Amy Dowd is completing negotiations with six organizations that will provide so-called "in-person assisters," trained to walk prospective enrollees through what for many could be uncharted territory: Figuring out which insurance policy to buy. A 10-employee call center to answer questions — before directing enrollees to an insurance agent or broker to complete the transaction — opened just last Wednesday.

"We don't have a set target we're expecting for enrollment," said Dowd, a health care consultant hired to run Idaho's exchange in April. "Our goals for our open enrollment period are to educate, get the word out that this is available."

Idaho's exchange was easily the 2013 Legislature most-disputed issue. Some conservatives blasted the vote, backed by Gov. C.L. "Butch" Otter, to join 16 other states in creating its own exchange, rather than defaulting to a federally-run model. They said it was bowing to what they called Obama's socialist vision.

Even as the Capitol drama unfolded, some 6,000 Idaho insurance agents feared they'd be barred from selling plans, a worry that didn't materialize: The exchange's 19-member board preserved a significant role for them, ensuring they can continue earning commissions. Meanwhile, in-person assisters, at about 150 locations throughout Idaho, will provide only technical advice to callers.

For instance, the Idaho Hospital Association director Steve Millard expects 200 employees at his lobbying group's 47 member hospitals who already work with uninsured patients on payment options to take the required 30-hour training session required to educate prospective enrollees about Idaho's exchange.

After the 30 minutes estimated for each call, however, Millard says they'll refer callers to brokers and agents to complete purchase of individual plans.

So far, seven insurance carriers will be offering 146 different health and dental plans for exchange participants who will get tax credits based on how much they earn, part of Obama's plan to make policies more affordable.

There have been hiccups: On Thursday, the U.S. Department of Health and Human Services announced small businesses — fewer than 50 employees — in Idaho and elsewhere can't apply online until Nov. 1, a month's delay.

Idaho's exchange hasn't come cheap.

So far, a $20.3 million federal grant has paid startup costs, like the upcoming marketing campaign run by Boise's Gallatin Public Affairs. Legal fees are running into the hundreds of thousands.

Another $50 million from DHHS is now on the horizon, for additional marketing, initial operation costs and building Idaho's own information technology system to collect enrollee's information — to replace the federal data hub the state has been forced to use, likely through at least Oct. 1, 2014, or risk missing important deadlines.

Stephen Weeg, chairman of Idaho's exchange board and a former Pocatello health care executive, concedes it's "a substantial chunk of change." Still, he insists, it's better to spend more to build a robust information technology system initially to avoid problems with future operations that could drive up costs.

"Sometimes, you can shortchange the front end, and pay for it in the back end," Weeg said. "We're going to be as frugal as possible."


Idaho's insurance exchange is due to begin enrolling people for coverage Tuesday, the statutory deadline under President Barack Obama's health care overhaul back in 2010. Here's a look at Idaho's exchange, by the numbers:

— 5 1/2 months: The 19-member exchange board appointed by Gov. C.L. "Butch" Otter had only since April to create a state-run exchange by the federal government's Oct. 1 enrollment-start deadline.

— About 200,000: The estimated number of Idaho residents who may be eligible for federally subsidized insurance via the exchange; Amy Dowd, the exchange director, isn't publicly setting a target on just how many people she hopes to enroll by next March, when the first open-enrollment deadline ends.

— Jan. 1, 2014: That's when coverage is due to start.

— $91,053: The average annual salary of the exchange's six full time staff members. Director Amy Dowd earns $175,000, finance chief Pat Kelly is being paid $110,000, communications head Jody Olson is getting $90,000, operations project manager Alberto Gonzalez is getting $82,500, policy analyst Moriah Nelson is getting $54,5000 and administrative assistant Alison Verrinder, the exchange's lone hourly employee, is earning the equivalent of about $34,000.

— $3.5 million: The initial budget to pay for newspaper, radio, TV, billboard and Internet advertising that's due to start in late October, about a month after enrollment begins.

— $70 million: Following a $20 million federal grant banked earlier this summer, the Idaho exchange is seeking another $50 million from the U.S. Department of Health and Human Services to pay to build Idaho's own data hub to process financial and medical data of enrollees — and operate the exchange during the first year.

— Seven carriers: Four nonprofit companies, Blue Cross of Idaho, BridgeSpan Health Company, PacificSource Health Plans and SelectHealth will be offering health insurance policies, with Blue Cross and PacificSource offering dental plans, too. Three additional companies — Delta Dental, Best Life and Health Insurance Co. and The Guardian Life Insurance Co. of America — are offering dental plans.

— $188,480: A single payment, in a check dated Aug. 21, to Boise law firm Hawley Troxell, whose lawyers are advising the exchange. Mike Stoddard, the lead attorney for the firm, is billing the exchange $285 hourly for his advice, according to a contract obtained by The Associated Press.

— Six organizations, 150 locations around Idaho: That's the number of groups and outlets providing so-called "in-person assisters," to help Idaho residents seeking more information about the 146 individual, small group and dental plans offered via Idaho's insurance exchange after its Oct. 1 rollout. In-person assisters will be able to answer general questions about plans' technical details, but will refer potential exchange enrollees to insurance agents and brokers to complete purchase of policies.

— (855) 944-3246: The phone number of the 10-employee call center in Boise where Idaho residents can seek information about the exchange, its carriers, its policies and how to sign up. Call center employees may also shift callers to agents and brokers to complete enrollment.


Copyright 2013 The Associated Press.

Betsy Z. Russell
Betsy Z. Russell joined The Spokesman-Review in 1991. She currently is a reporter in the Boise Bureau covering Idaho state government and politics, and other news from Idaho's state capital.

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