Health Care Reform
Federal Health Exchange Today, State-based Exchange Tomorrow?
Spring has sprung – we are less than 200 days until the inaugural open enrollment period for the nation’s Health Insurance Marketplaces. We are deep in the throes of Health Care Reform implementations for the public health insurance exchanges across the nation. Our fingernails are getting dirty with the details of rules, processes, testing and expected results. We are state-based, we are FFE, we are FFE partnerships, we are launching October 1st, 2013.
Yet, while this is an exciting time exploring, researching, engineering, re-engineering and getting nervous about shrinking timelines. I cannot help but to think ‘ahead’; what happens next; because surely this will not be the end.
Getting across the finish line is the primary focus for all States whether in a State-based exchange model or in a Federally Facilitated Exchange (FFE) model.
But, what about the future?
Getting past this deadline may seem like the end but it is really a beginning – how will we improve these models in the future? What gaps exist in the implementations that need to be addressed post-open enrollment? What considerations should be made for a possible transition from an FFE to a State-based exchange in future years? Has the State best prepared themselves to grow beyond the 2014 deadlines? Or has the State simply instituted another siloed social program with no real efficiencies gained in the delivery of other programs?
Depending on the State, you will find varying degrees of preparations for the future; however, certain States are certainly models for other states to follow in delivery. The State of Maryland is one example. As an Early Innovator State, Maryland is leading the way and encouraging others to following the footsteps of their phased approach to ACA implementation as well as, an overall modernization approach to social program delivery.
Much of their work can be leveraged by states that may choose to transition to a state-based exchange in the future. Many resources are published and available for review at the website, Maryland Health Benefit Exchange.
Depending on the states current infrastructure, it may be able to leverage some of Maryland’s work in order to prepare for their own transition from an FFE model to a state-based model and still take advantage of 90/10 funding available to modernize Medicaid eligibility systems with delivery all the way up until December 31, 2015.