Exchanges take insurers on roller-coaster ride


At the end of the first open enrollment period, what insurers don't know exceeds what they do know, Rocky Mountain Health Plans President and CEO Steve ErkenBrack said Thursday at the second national health insurance exchange summit in the District of Columbia. Payers aren't sure to what extent the significant pent-up demand will normalize over time, he noted.

Faced with such unknowns, it has been a roller coaster ride for insurers selling plans on the new health insurance exchanges, leaders from three insurance organizations told the audience.

"You thought you made progress with a particular state, with one entity or stakeholder only to have another stakeholder create another fire," said Jeff Grahling, vice president of innovation & product development at St. Louis-based Centene Corporation.

For Centene, a major challenge lies in understanding all the rules and regulations, especially since each state market has its own requirements.

Enrolling the uninsured population was particularly challenging for insurers, according to Blue Cross Blue Shield Association Vice President of State Affairs Kim Holland, noting that only 26 percent of the 8 million exchange enrollees previously lacked insurance. Going forward, she recommended insurers better understand how consumers make decisions as well as fully inform consumers about available coverage options to encourage the uninsured market to sign up for exchange plans.

Holland also called on insurers to work with policymakers to evolve healthcare reform laws at the state or federal level to make sure consumers have the affordability and choice they want and need.

When sharing their exchange experiences, all of the panelists addressed the ever-present negativity surrounding the Affordable Care Act. They pointed to public perception that enrollment was unsuccessful, despite enrollment figures showing otherwise, and the difficulties of dealing with the politicization of the issue.

However, ErkenBrack, who sat on the board of directors for the Colorado Health Benefit Exchange, acknowledged an increasing awareness that carriers weren't the bad guys but they had experts to bring to the exchange table. By no longer demonizing payers, he said exchange leaders could see how the marketplace could help both insurance companies and consumers.

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