Exchange, marketplace: What's in a name (change)


When I was pregnant two years ago, my husband and I spent hours and hours discussing names for our daughter. We wanted a name that would sound good with our last name; we preferred something Italian to represent my heritage; we favored something unique without being outlandish. Really, we wanted a perfect name that would just fit our precious soon-to-be child.

That's why we discussed about a million options before we decided on the one ideal word that would literally identify our daughter for the rest of her life. We didn't take the challenge lightly.

Unfortunately, it doesn't appear that the U.S. Department of Health & Human Services took a similar approach to naming the new and innovative (to the insurance industry, at least) way for consumers to shop for health insurance. The reform law slapped it with a "health insurance exchange" label and HHS dutifully moved on.

Fast forward two years and HHS officials are quietly rebranding exchanges as "marketplaces," likely because the public has such a negative reaction to the word "exchange." But shouldn't they have done that public research, you know, before making the name "exchange" official?

But here's the more salient point: Will renaming exchanges as marketplaces or whatever name regulators invent suddenly make hundreds or thousands of people flock to the online sites to sign up for insurance? I doubt it.

Even if HHS rebranded exchanges as "the simplest way to shop for health insurance" (long and wordy as that might be), it still doesn't guarantee success despite its obvious meaning. The only things that can truly ensure exchanges are effective is outreach, education and time.

This is a gigantic change for consumers to wrap their heads around, assuming they even know exchanges exist. Websites like Travelocity, Expedia and Kayak didn't become household names or attract consumers overnight, so why would exchanges? Those companies even spent millions of TV, radio and print advertisements to promote their products, something HHS has yet to do.

I understand the term exchange doesn't adequately convey any clear meaning about the product to consumers. And I'm not opposed to HHS shaking things up a bit, but I wish it had done its due diligence a long time ago to help provide the most solid foundation on which to serve its central reform project to the American public.

And just because the term exchange was used in the actual reform law doesn't mean HHS was compelled to follow suit. Choosing a more accurate and descriptive name after the reform law was passed would be akin to my husband and I temporarily selecting a favorite baby name, perhaps even sharing it with some close family and friends, but then changing our minds before our daughter was born.

Yes, we started with one name and ended with another. But only a few people were ever aware that we changed our minds. It's not like we signed the birth certificate and then filed a petition with our local civil court two years later to give our daughter a brand new name.

Even if we did go through a name-changing process, it wouldn't make a lick of difference to our daughter's personality, her inner essence. She's the same wonderful child that she was when she was born, regardless of what we call her.

The same holds true for exchanges. They're still the same online health insurance shop whether they're called exchanges, marketplaces or any other name. At the very least, I hope HHS has made a final call on using the term "marketplaces" so there's no more discrepancy or confusion regarding these online insurance shops. - Dina (@HealthPayer)