State health reform planner meets with business council

States have until January 2014 to launch their own insurance marketplaces under the Affordable Care Act ”“ which will offer businesses new coverage plans for their employees. But while plans are finalized, Jeannette B. DeJesús, the governor”™s special adviser on health reform, said businesses can rest assure that the state is considering their interests in the matter everyday.

Speaking to the Business Council of Fairfield County July 16 at the Stamford Ferguson Library, DeJes̼s outlined the stateӪs major plans. So far, few concrete plans are in place and itӪs unknown how much anything will cost.

“This is a time of critical change, flux ”¦ and many decisions to be made,” DeJesús said. Regardless of the heated debate behind the act, DeJesús said the state was moving forward on the critical issue.

First, headway is being made on the stateӪs affordable health insurance exchange. In lieu of a national exchange, the state will be working with insurance providers in the state, to create an online marketplace for individuals and businesses to shop for insurance plans. DeJes̼s said her hope is that the exchange will improve the quality of care while simultaneously reducing the cost by offering more transparent and competitive plans.

Additionally, the state is thinking about creating an alternative to purchasing through the state”™s exchange or using Medicaid, called a basic health plan. With the passage of the ACA, fewer people are eligible for Medicaid in the state, leaving thousands of people uninsured and most likely unable to afford insurance through the exchange. The basic health plan would be offered to residents under the age of 65 with an income between 133 percent and 200 percent of the federal poverty level. The plan would be similar to Medicaid and offer only essential coverage, acting as a benchmark for all other coverage plans in the state.

A third project in the making is an all-payer claims database that would be available for public use. The database would showcase all insurance claims, making it possible to answer, “What are the most prevalent health problems in my community?” and “What areas offer the cheapest care?” DeJesús cautioned the data wouldn”™t be perfect or offer any easy answers, but would be a valuable tool. Legislators would be able to prioritize health-related initiatives to serve their districts and businesses could study the data to ensure their insurance plans are cost effective and a good fit for their employees.

The state has until October 2013 to create its plans for the federal government”™s approval and everything will be officially launched in January 2014.