Reform Update: Exchanges 'on target' for Oct. 1, Sebelius says

Health insurance exchanges in every state are set to go live in 18 weeks, and HHS Secretary Kathleen Sebelius promises that open enrollment will begin as scheduled.

“We are on target and ready to flip the switch on Oct. 1,” Sebelius said during a conference call with reporters. Thirteen states, she noted, recently have announced that approved rates on the exchanges will be about 20% lower than previously estimated, and lower than what consumers were paying for comparable plans before.

She explained how federal education and enrollment efforts are in a tricky period because officials want to raise awareness as much as possible but don't want to give the public the misimpression that they can sign up right now. While consumers can visit the government website, www.healthcare.gov, and create an account, it's still too early to do much else.

Sebelius lamented that the federal budget sequester cut about $15.5 billion from the HHS budget, so the department will have less money to spend on enrollment outreach efforts than movie studios have to promote their latest cinema releases. Nevertheless, Sebelius said she expects all resources to well used. To that end, the HHS and the Health Resources and Service Administration's Office of Women's Health is sponsoring the Care Counts Challenge, a contest in which contestants offer educational tools informing women about their state's health insurance exchange.

The Obama administration has rebranded the insurance exchanges as “marketplaces.” Sebelius explained that the term exchanges “didn't resonate” with the public and that “marketplace” was a word people understood easier and that translated better into non-English languages.

In the meantime, HHS must counter conservative efforts to persuade young adults not to buy health insurance, which if successful could drive up premiums in the exchanges. Sebelius described it as “a pretty dismal effort,” and said she hopes parents and others will spread the message that even healthy young people can suffer a serious accident or receive a diagnosis of a life-threatening illness—and face bankruptcy from medical costs.

HHS Secretary Sebelius announced that training grants will be available in a few weeks for health insurance exchange “navigators” who will help consumers find their way through the new marketplaces when they go live Oct. 1. Navigators will be expected to do outreach and education—tasks that others assisting in the process, described as “enrollment assisters” and “certified application counselors,” will not be authorized to do.

But navigators, unlike licensed insurance brokers, will not be able to recommend a plan to consumers they counsel. In many states, licensed brokers will be able to sell exchange plans.

According to a recent CVS Caremark Corp. survey, the navigators and their colleagues have their work cut out for them. The company's survey found that 36% of respondents likely to enroll in health insurance exchanges needed more information, and almost half of those eligible for a federal premium subsidy to help them pay for coverage didn't know about the exchanges or the subsidies.

In an effort to fill this information gap, CVS has launched an outreach program which includes a website, brochures and displays at its 7,400 stores and 650 MinuteClinic retail clinics.

One conservative organization opposing the Patient Protection and Affordable Care Act was not pleased. The St. Paul, Minn.-based Citizens Council for Health Freedom is urging its members to call the CVS community relations department telling them “don't promote Obamacare,” that they “don't want to be hassled by 'navigators' ” as they shop, and that CVS may be alienating customers who oppose the ACA.

Most Massachusetts residents are satisfied with their healthcare under the state's Obamacare-like system, and despite occasional long waits to see a physician, cost appears to be their main concern, according to a survey conducted by the Massachusetts Medical Society.

Seven years into the Massachusetts's so-called Romneycare reform model—the inspiration for the federal healthcare law—Massachusetts is often seen as a harbinger of things to come for the national reform experience.

The telephone survey of 417 Massachusetts adults, conducted May 14-16, found that 56% of respondents were “very satisfied” with their care and 28% were somewhat satisfied. Read more.

Follow Andis Robeznieks on Twitter: @MHARobeznieks