Oklahoma is among the states that will not create its own health insurance exchange as part of the mandates set forth through the federal health reform law.
In November, Gov. Mary Fallin announced Oklahoma would not create a state-based health insurance exchange. Instead, the federal government will establish and operate Oklahoma's exchange.
Starting in January 2014, people who are uninsured and meet certain income guidelines will be able to buy insurance directly through a health insurance exchange, known as the Health Insurance Marketplace, according to the U.S. Department of Health and Human Services.
Michael Mahoney, vice president of consumer marketing for GoHealth, answered questions about how health insurance exchanges will work. GoHealth is primarily a software company focused on the insurance industry.
What reasons have you heard states give for not creating their own exchanges?
Health insurance exchanges are part of the Affordable Care Act, the federal health reform law that some refer to as “Obamacare.” These exchanges will serve as online marketplaces where the uninsured can shop for health insurance.
“Truthfully, I believe the decision to leverage the federal exchange is more of a non-decision than a decision,” Mahoney said. “It's states not knowing what's going to happen, so they say, ‘Well, we'll leverage the federal exchange. If we decide to make our own later, we can always do that later.'”
Mahoney explains GoHealth as “an exchange before there were mandated exchanges.” GoHealth offers insurance quote comparisons on its website. The website is similar to Priceline.com for plane tickets.
GoHealth has a staff of people to operate its site and has a platform that allows the site to be updated frequently, he said.
Mahoney said if a state had an online exchange website, that website would need to have the capability to be updated as the latest information on what health insurance premiums and plans was released.
“I'm not sure that any state that we've talked to is set up with the capacity to handle that,” Mahoney said. “They're just scrambling to get a website up. I think Oklahoma is in with a lot of states, and they say ‘We don't know what's going to happen so we'd rather not take on this additional risk.'”
What discussion is there around the usability of the health exchange website?
Mahoney said one of the challenges that officials will face is educating people on how to use the exchange website.
Most people have a general understanding of the Internet and email. But the general population is not well-versed on insurance jargon, he said.
People who will use the exchange probably either will have insurance through their jobs and are comparing insurance opportunities outside of that coverage, or they're people who have never been insured or are underinsured, Mahoney said.
“Those people are going to be looking at words, like ‘coinsurance, deductible, copay, premium, provider network' for the first time,” Mahoney said. “There's a huge concern in the marketplace that people are going to be uninformed when making their decisions.”
What should people keep in mind when using the exchange?
Mahoney said the insurance buying process will be intimidating at first, but it will grow easier with experience.
“If I said, ‘Hey, you're going to buy your own home — you're going to act as your own mortgage broker,' you would say, ‘I don't know any of that language,'” Mahoney said. “Well, now you're in charge of choosing your own health plan, and whereas before you didn't have any health insurance, and you couldn't worry about it, or you had group insurance, and you just checked a box.”
People will have more responsibility regarding their health insurance coverage, he said. Hopefully people make the best decisions for their dollar, he said.
“The biggest mistake a person can make is making a buying decision based on price alone,” Mahoney said. “It's like buying your first car and saying, ‘This one is $10,000. I'll buy that one.' You've got to compare all the different features.”