The federal government expects Connecticut will be one of a handful of states that will successfully install a health insurance exchange by October 2013 ”“ but the man leading the effort here warned of “bumps in the road” along the way.
A year before open enrollment is scheduled to begin in advance of federal health reform, the Connecticut Health Insurance Exchange settled on an architect in Deloitte Consulting, which will build an operating system and website that will determine eligibility and enroll individuals, families and small businesses wishing to purchase coverage through the exchange.
“Our 12-month sprint begins today,” said Kevin Counihan, CEO of the Connecticut Health Insurance Exchange, providing an update to the exchange board led by Lt. Gov. Nancy Wyman. “This is not going to be smooth, these next 12 months ”“ we”™re going to be making mistakes. We”™re going to come to you with some bumps in the road. There are going to be times when you”™re going to say, ”˜what were you thinking?”™ All I”™m telling you is that we”™re committed to meeting the deadlines and being operational by Oct. 1, 2013.”
That will depend in large part on the performance of Deloitte Consulting, whose parent Deloitte Inc. is among Fairfield County”™s largest employers via offices in Stamford and Wilton. This past summer, Deloitte won an agreement to receive state incentives in exchange for adding at least 200 employees here, under Gov. Dannel P. Malloy”™s First Five program.
The state did not immediately disclose the size of the Deloitte Consulting contract, but said the funding will come from a portion of the $107 million grant the state received in August from the Center for Medicare & Medicaid Services (CMS), with Connecticut one of the first half-dozen states to receive a “level two” award from CMS. In its July application for the federal funding, Connecticut estimated it would cost $34 million to run the exchange in its first full year of operation in 2014.
It was the second state health insurance exchange contract landed by Deloitte Consulting, which will also create an exchange for the state of Washington. Connecticut did not reveal other bidders for the contract ”“ Norwalk-based Xerox Corp. has been actively marketing its own health insurance exchange design services, last month winning a $72 million deal from the state of Nevada.
As Deloitte Consulting gets to work on the nuts and bolts of the exchange, the board is still wrestling with a host of other details, from how to get consumers into the exchange, to the types of coverage that can be offered, to paying for it all.
“My concern has to do with the fact that we may be approving an essential health benefits program that indeed covers pediatric root canals, crowns, orthodonture, eyeglasses, contact lenses ”“ and I know that ”¦ most small businesses don”™t provide these benefits now,” said Mickey Herbert, former CEO of ConnectiCare Inc. “In fact, I ran a small business for eight years in Bridgeport, and we didn”™t provide them. I”™m just concerned that it”™s going to visit absolutely undue hardships on the small business community that”™s now going to have basically kind of a mega-mandate on them.”
As states absorb the mandates included in the Accountable Care Act, Connecticut is one of 15 states that are bypassing an off-the-shelf federal prototype and designing a health insurance exchange from scratch, with Counihan indicating CMS believes it is only one of half of that number that will make it under the wire in time.
“One of the major challenges ”¦ is the need to work every day with imperfect information and ambiguity,” Counihan said. “It”™s frustrating sometimes for us not to be able to respond precisely to a board request on something that”™s a very reasonable, rational and good question (except) with the words: ”˜we don”™t know.”™
“But that”™s the world we”™re living in,” he added. “We work with the information we have and keep moving.”
