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Health Insurance Marketplaces: The First 8 Weeks

Friday, November 22, 2013

Health insurance marketplaces, or exchanges, opened October 1, and while states have released some enrollment data, and much of the attention has been on the initial technical challenges, there has been less information about overall consumer experience.

Who is trying to access the marketplace websites, and how many have successfully enrolled? Of those who shopped but did not enroll, why not? Do they plan to sign up later? What kinds of people are enrolling? Are they older and sicker, and will that make coverage more expensive for everyone? Why has early enrollment tilted more toward Medicaid, as opposed to private insurance, and will that trend continue?

Sara Collins, vice president for the health care coverage and access program at the Commonwealth Fund, shared the results of a recent Commonwealth survey on experiences in the marketplaces.

Mila Kofman, executive director of the DC Health Benefit Exchange Authority, discussed early experiences in the Washington, DC marketplace.

Dan Schuyler, director of exchange technology at Leavitt Partners, and former director of technology for Utah’s health insurance exchange, addressed technology and other challenges that marketplaces are facing.

Matt Salo, executive director of the National Association of Medicaid Directors, discussed the status of Medicaid enrollment, which has outpaced private insurance enrollment.

Katy Caldwell, executive director of Legacy Community Health Services, a federally-qualified health center in Houston, explained her clinic’s efforts to actively help patients with enrollment.

Ed Howard of the Alliance and Sara Collins of Commonwealth co-moderated.

Contact: Marilyn Serafini (202) 789-2300

Follow the briefing on Twitter: #ACAmarketplace

The event was sponsored by the nonpartisan Alliance for Health Reform and The Commonwealth Fund.


Transcript, Event Summary and/or Webcast and Podcast

Transcript: Full Transcript (Adobe Acrobat PDF), 11/22/2013
Full Webcast/Podcast: Full Video from C-SPAN

Speaker Presentations

Caldwell Presentation (Adobe Acrobat PDF), 11/22/2013
Collins Presentation (Adobe Acrobat PDF), 11/22/2013
Kofman Presentation (Adobe Acrobat PDF), 11/22/2013
Salo Presentation (Adobe Acrobat PDF), 11/22/2013
Schuyler Presentation (Adobe Acrobat PDF), 11/22/2013
Full Presentation (Adobe Acrobat PDF), 11/22/2013

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Agenda (Adobe Acrobat PDF), , 11/22/2013
Material List (Adobe Acrobat PDF), , 11/22/2013
Source List (Adobe Acrobat PDF), , 11/22/2013
Speaker Biographies (Adobe Acrobat PDF), , 11/22/2013

Offsite Materials (briefing documents saved on other websites)

Reflecting on Reform - The Marketplace Experience: Month One, The Commonwealth Fund, 11/4/2013
Letter to State Insurance Commissioners (Adobe Acrobat PDF),Center for Medicare and Medicaid Services, 11/14/2013
Americans' Experiences in the Health Insurance Marketplaces: Results from the First Month, The Commonwealth Fund, 11/4/2013
Health Insurance Exchanges, Alliance for Health Reform; Robert Wood Johnson Foundation, 10/1/2013
Helping Consumer Understand Their Coverage Options, from Coast to Coast, The Commonwealth Fund, 11/1/2013
Under Pressure: An Update on Restrictive State Insurance Marketplace Consumer Assistance Laws, The Commonwealth Fund, 10/31/2013
How Will You Fare in Obamacare Exchanges, The Heritage Foundation, 10/16/2013
Health Insurance Marketplace: November Enrollment Report (Adobe Acrobat PDF),Department of Health and Human Services, 11/13/2013
CHIP Roll Out and Early Enrollment - Implications for the ACA, First Focus, 10/23/2013
Looking Beyond the Technical Glitches: A Preliminary Analysis of Premiums and Cost Sharing in the New Health Insurance Marketplaces, Breakaway Policy Strategies; Robert Wood Johnson Foundation, 11/5/2013
Patient Protection and Affordable Care Act, Alliance for Health Reform; Robert Wood Johnson Foundation, 10/1/2013
State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the Affordable Care Act, Kaiser Family Foundation, 11/1/2013
Why New Medicaid Enrollment is Soaring, Stateline, 11/6/2013
Reflecting on Health Reform: Buckeye Bellwether?, The Commonwealth Fund, 10/30/2013
Covering Young Adults Under the Affordable Care Act: The Importance of Outreach and Medicaid Expansion, The Commonwealth Fund, 8/21/2013
Pros and Cons of the President's Policy Fix for Health Plan Cancellations, The Commonwealth Fund, 11/18/2013
Implementing the Affordable Care Act: Key Design Decisions for State-Based Exchanges, The Commonwealth Fund, 7/11/2013
Measuring the Outcomes of Healthl Reform: Opportunities for Federal and State Policymakers, Health Affairs, 10/28/2013
In States' Hands: How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans, The Commonwealth Fund, 9/5/2013
Marketplace Enrollment Helpers (Adobe Acrobat PDF),Alliance for Health Reform; Robert Wood Johnson Foundation, 9/27/2013
Outspoken Group Bears Brunt of Canceled Health Insurance Policies, Wall Street Journal, 11/1/2013
Who Needs ,, 11/15/2013


Dan Schuyler

It’s not easy to compare prescription drug costs and doctors covered by each plan on the health insurance marketplaces, Katy Caldwell, executive director of Legacy Community Health Services, stated at a November 22 Alliance briefing, Health Insurance Marketplaces: The First 8 Weeks.

Matt Salo

In the DC exchange, when the proposed rates became public, some insurers lowered rates and added new plans to be more competitive, Mila Kofman, executive director of the DC Health Benefit Exchange Authority, stated at a November 22 Alliance briefing, Health Insurance Marketplaces: The First 8 Weeks.

Sara Collins


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