For exchange enrollment success, let's agree to disagree


The Affordable Care Act's success hinges on strong enrollment, especially among young, healthy consumers--something all payers and policymakers can agree on. But partisan bickering could prevent insurers from getting those coveted young sign-ups.

That's what's happening in West Virginia, a state with one of the most medically underserved populations. Healthcare workers, social workers and insurance agents have pointed to partisan disagreements and attack ads for discouraging enrollment among young, working-class adults who would benefit the most, according to The New York Times.

"The controversy about Obamacare does seem to have interfered with people's ability to sort out the value of the marketplace for getting health insurance for themselves," James B. Becker, M.D., medical director of the state's Medicaid program, told the Times.

Just the fear of being linked to the ACA prompted West Virginia to turn down federal dollars to promote private exchange coverage to the uninsured.

Arkansas struggled with similar political opposition to healthcare reform. In fact, Cynthia Crone, the insurance deputy commissioner of the Arkansas Health Connector, cited differing political views as the biggest challenge to exchange implementation.

Anti-reform sentiments within the Arkansas legislature prevented exchange leaders from giving the public accurate information about the reform law, coverage options and financial assistance. The Republican-led House and Senate viewed the marketplace's "get enrolled" campaign as wasteful spending--despite the potential economic benefit of $550 million if the Arkansas Health Connector got people signed up. Both sides of the aisle should acknowledge that educating new consumers is key, as many lack the information needed to make smart health insurance decisions.

Increasing dislike of the reform law has kept many Republican-controlled states from creating their own exchanges. They should take note of what happened in Kentucky. The state's Republican-led Senate and Democratic-led House embraced its exchange and established Kynect as a state agency under the Cabinet for Health and Family Services. That allowed the exchange to take advantage of the state's accounting systems, policies and procedures, and helped it become one of the country's most successful marketplaces.

But it's not just Republican reproach of the law that threatens future enrollment--a lack of messages from Democrats won't encourage constituents to sign up for coverage during the next open enrollment period. Most Democrats in battleground races avoid the topic, with half the candidates omitting the ACA entirely from their websites, according to The Hill. With no defense or even mention of the law, people won't know about its benefits to the un-or underinsured.

Some lawmakers might not like the ACA (perhaps rightfully so), but it's what we've got and we have to make it work for payers to truly drive down healthcare costs and improve outcomes. While we wait for Republicans to agree to disagree and accept the ACA as law of the land, insurers forge ahead with plans to expand exchange offerings. As payers finalize exchange plans for 2015, hopefully lawmakers from both sides of the aisle will at least commit to public education campaigns to help people get the information they need to become informed healthcare decision-makers and give the law the ability to lower the rate of uninsured. - Alicia (@FierceHealth)

Related Articles: hearing: Partisan fights, govt. apologies, blame all around
Arkansas Health Connector's Cynthia Crone on overcoming exchange barriers
What payers learned during first open enrollment
Exchange enrollment: Tips from state marketplaces
Insurers to expand exchange offerings next year