Greg Mellowe, policy director of Florida CHAIN, a nonprofit whose mission is to make sure every Floridian has health coverage. Mellowe, 46, has been closely watching the forthcoming insurance exchange that will launch Oct.1. The kingpin of the health-care reform law, the exchange will make insurance coverage available to most Americans. He spoke recently with staff writer Marni Jameson.
CFB: The launch of the insurance exchange is a complex undertaking for every state. How well prepared is Florida?
In almost every way, Florida has been procrastinating and refusing to move forward, so we are at a disadvantage. But the blame for not being fully prepared isn't all ours. We're still waiting for information from the federal government. We don't know, for instance, what insurers are going to be approved to provide qualified health plans in the marketplace, and what their rates will be. We're waiting and wondering.
CFB: When will we know the choice of plans?
We believe, based on the state government's filings, that 10 insurance companies have applied to have qualified plans in the new exchange. On July 31, the federal government will make its final decision about which plans are approved, but we don't know when they will make that information public. We hope it's before Oct. 1.
CFB: What does the state need to do?
We have several really important pieces to put in place. For one, we have to get navigators who will work for the marketplace, and do outreach to help different groups access coverage. They will target low-income groups and second-language groups, those who have never had health insurance and for whom figuring it out would be a struggle.
CFB: Why did Florida opt to rely on the federal exchange instead of creating its own?
Florida, like 26 other states, chose to go with the federal exchange, in part because of the cost and complexity of setting up a state exchange, which 17 states opted to do. Another seven are doing a partnership.
CFB: Many speculate that the new website will crash from overuse when it launches. How likely is it that the website will work well when it kicks off?
There will be some troubleshooting, and some setbacks as everyone works to figure this out, but I think it will work. Also open enrollment goes from Oct. 1 through March 31. So residents have time.
CFB: Which Floridians should be paying attention?
Most Floridians won't see a big change because they already have coverage through their employer or have Medicare. The one in four who are uninsured need to know how to use the exchange, and understand that they can not only find varied levels of coverage, but also, depending on their income, could get a tax credit to help make insurance affordable.
This is also a great benefit to employees who are "job locked," those who want to leave their jobs to start their own businesses but can't because they wouldn't be able to get health coverage. Now they can.
CFB: How will this affect employers?
Small-businesses (those with fewer than 50 employees) will be able get employee coverage through the Small-Business Health Option Program — SHOP. The Shop options will expand as larger pools of employers access the exchange. The Shop is also the pathway for small employers to access the tax credits available to small businesses. In 2016 employers with up to 100 employees will be able to use the Shop.
CFB: Since Florida CHAIN's role is to get affordable health coverage for all Floridians, will you be out of work once all this rolls out?
I would like to see that! It would be amazing if our mission were completely realized. But I don't think this will end uninsurance. I don't see the exchange as a panacea but as a big step in the right direction. Once this gets implemented, we'll see what remains to be done, including how we can expand Medicaid.
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