In every state on Oct. 1, health insurance exchanges under the Affordable Care Act will begin enrolling customers for plans that take effect January 1, 2014.
The idea behind the exchanges is to allow consumers to see health insurance plans side-by-side so they can choose the plan that’s right for them, their business, their family and their wallet.
Gov. Bobby Jindal made the decision early on that Louisiana’s health exchange would be federally-run. But state insurance officials still have an essential role in setting it up and keeping it going.
Insurers in every state had to submit plans to the federal Center for Medicaid and Medicaid services for approval. But in states like Louisiana, that have declined to set up an exchange on their own, federal officials will also assume primary responsibility for operating the marketplace, including setting up the website and reaching out to consumers. And when you call with questions about the health exchange, people paid with federal government money will answer your questions.
But state Insurance Commissioner Jim Donelon said his office is still playing an essential role.
"Any form of insurance marketed in Louisiana has to first be approved by the Louisiana Department of Insurance," said Donelon. "And we reviewed them line for line, page for page to determine that all provisions are in accordance with Louisiana law."
The state reviewed thousands of plans submitted by the insurance companies taking part in the exchange: Humana, Vantage, Blue Cross-Blue Shield, and the Louisiana Health Cooperative.
Donelon said his office is responsible for making sure plans fall within state standards, regardless of who set up the exchange.
"I always prefer to have authority on behalf of our constituents over the health insurance market place but having said that, the feds are doing it in most states and I think it will work," said Donelon.
The most familiar name in the bunch is Blue Cross Blue Shield, which currently holds about 75 percent of the market in Louisiana.
BCBS Health care Reform Consultant Wes Miller says the company’s market share could grow once the exchange is open.
"We are the only insurer in Louisiana that actually has plans in every single parish and every single zip code in the state," said Miller. "And we’re pretty confident that we’ll be very competitive on the exchange."
Blue Cross-Blue Shield will have some new competition though. A provision of the Affordable Care Act called for cooperatives to be set up in each state. Louisiana is one of 24 states that managed to get money for a co-op before the sequester hit and the funding dried up.
Louisiana Health Cooperative Vice President Tony Cimino said they are a non-profit insurer for the people by the people.
"It was a group of individuals, providers and community leaders and business owners that supported having an alternative in this state," said Cimino.
As new-comers, Cimino said the co-op had to craft health insurance plans from scratch, which has lead to a lot of curiosity about what they’ll have to offer once the exchanges open.
Insurance Commissioner Jim Donelon thinks Louisiana could use the competition.
"No doubt about it," said Donelon. "I am a firm believer that the best way to control cost and to serve consumers is through competition with any insurance product."
In the second part of this two-part series, we’ll talk prices of the new plans being offered and how to navigate the enrollment process.
**Deputy Commission of Public Affairs with the Dept. of Insurance Ileana Ledet has told WRKF the insurer Coventry has opted out of the health insurance exchange. The online story has been corrected to reflect this change.
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