Amy Snow Landa, Seattle Times, Author at �鶹Ů�� Health News

Washington State To 8,000 Obamacare Enrollees: We Goofed On Cost Estimate

Amy Snow Landa, Seattle Times — Mon, 11 Nov 2013 18:25:50 +0000

This story was produced in partnership with

About 8,000 Washington residents will soon receive letters informing them that the price they are expecting to pay for health insurance purchased on the new online exchange marketplace is incorrect.

The letters are part of an effort by the Washington Health Benefit Exchange, which operates the exchange, to correct a major error that resulted in the miscalculation of tax credits that help qualified enrollees pay for insurance premiums.

The exchange identified the root cause of the miscalculation in late October — by the third week of open enrollment on the exchange website, called Washington Healthplanfinder. The exchange went public about the errors Oct. 25.

Since then, the exchange has been recalculating the premium subsidies for people who were told they qualified for a tax credit. The letters, set to go out next week, will have the proper credit, according to the exchange.

The process has been “slower than we expected,” exchange CEO Richard Onizuka said.

The problem has been a blemish on Healthplanfinder, recognized as one of the most successful of the new online insurance marketplaces that have been launched under the Affordable Care Act.

As the tax-credit miscalculation showed, the site has not been without problems, Onizuka said.

“I’m not ready to claim victory yet, and I think we still have challenges,” he said.

Affects Early Enrollees

The miscalculation of the federal tax credit affected those who enrolled in an exchange health plan during the first few weeks after the exchange’s Oct. 1 launch.

For those few weeks, Healthplanfinder was submitting applicants’ monthly income to the federal hub, which compiles data from federal and state agencies to determine whether an applicant is eligible for Medicaid or for a premium subsidy to purchase a health plan through the exchange.

But the federal hub was expecting annual income, not monthly, which resulted in the miscalculation.

Approximately 8,000 Washington residents were affected, which meant they were told they qualified for a higher tax credit amount than they actually qualified for based on their income and household size.

How could such an error occur? “We’ve asked ourselves that many times,” Onizuka said. “We are still trying to figure out how this happened.”

So far, Washington is the only state-run exchange that has reported making this type of error to the Centers for Medicare and Medicaid Services (CMS), which oversees the online insurance marketplaces and the federal hub.

The letters being sent to enrollees will be the first direct communication from the exchange informing them that the amount of their premium subsidy is less than they thought.

The mistake could mean a lot of work for people who already went through the process of choosing a health plan, as well as for brokers and in-person assisters who helped them.

Deja Vu?

Some people will probably have to go through the selection process all over, said Chris Free, an insurance broker at Rapport Benefits Group in Tacoma, who has been advising clients on enrolling in the health plans available through the exchange.

“People may have selected plans that are no longer in their budget” once their tax credit is recalculated, Free said. For those clients, “we’ll need to sit down and help them re-evaluate their decision,” he said.

Another problem for the exchange has been the capacity of the customer-service center to handle calls seeking information and assistance with their applications.

The exchange had expected about 2,000 calls a day. But the actual number is currently about 3,000 to 4,000 a day, Onizuka said.

In response, the exchange announced two weeks ago that it plans to add 145 new customer-service representatives through mid-December, which will double the call-center staff.

The first 20 of the new hires are going through training and are expected to start working the phones next week, Onizuka said.

A key goal is to significantly reduce the average wait time for callers, which is still about 20 minutes, Onizuka said.

The exchange is also preparing for an expected surge in activity on the website through the coming weeks, especially in mid-December. The deadline to enroll in coverage is Dec. 15 for people who want their coverage to begin on Jan. 1, 2014, and the first premium payment is due Dec. 23.

“What we learned from October hopefully will better prepare us for December,” Onizuka said.

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In Week Two, Washington State Exchange Enrollment Nearly Triples

Amy Snow Landa, Seattle Times — Wed, 16 Oct 2013 18:07:35 +0000

About 25,000 Washington state residents have enrolled in health plans through the state’s online insurance exchange marketplace during its first two weeks.

That figure is nearly triple the 9,500 residents who completed their enrollment during the first week that the exchange, called Washington Healthplanfinder, was open for enrollment.

An additional 37,000 people have completed applications to enroll in coverage but have not yet submitted their first payment, which is not due until December.

The , which operates Healthplanfinder, released its latest enrollment figures earlier this week.

Among the 25,000 state residents who have completed their enrollment, more than 13,000 are newly eligible for Medicaid coverage in 2014. Washington is among the states that chose to expand Medicaid eligibility to adults with income up to 138 percent of the federal poverty level, which is nearly $16,000 for an individual.

About 8,500 people have completed enrollment for Medicaid coverage that will begin immediately because they qualify under the current income criteria but, for one reason or another, had not previously enrolled.

The remaining 3,000 residents who have enrolled in coverage through Healthplanfinder have signed up for private health plans, called Qualified Health Plans, for coverage that will begin in 2014.

Traffic on the Healthplanfinder website held steady in the second week, with the number of total site visits nearly doubling to more than 1.4 million and the number of page views doubling to more than 5.5 million.

Phone calls to the customer service center in Spokane increased from more than 23,000 during the first week to more than 53,000 by the end of the second week.

The downside of the higher call volume is that the average wait time for a caller seeking help increased from 10 minutes and 25 seconds during the first week to 18 minutes in the second week. Exchange officials are reminding residents that if they are unable to wait for their call to be answered, they may receive a call back when a representative is available. They can also seek in-person help through the .

This story is part of a collaboration that includes and Kaiser Health News.

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Seattle Hospital Sues State Over Exclusion From Exchange Plan Networks

Amy Snow Landa, Seattle Times — Mon, 07 Oct 2013 12:57:03 +0000

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Seattle Children’s Hospital filed suit Friday over the state Office of the Insurance Commissioner’s “failure to ensure adequate network coverage” in several of the health plans sold on the state’s new online insurance marketplace, called Washington Healthplanfinder.

Most health plans now being sold through the state’s new health-insurance exchange do not include Seattle Children’s as an in-network provider. As a result, families that enroll in those plans could face significantly higher cost-sharing if they seek care at Children’s than if they seek care at the plans’ preferred providers.

The higher cost-sharing could seriously disrupt care for families currently receiving services at Children’s and could delay new patients from getting the specialized care they need, said Dr. Sandy Melzer, the hospital’s senior vice president and chief strategy officer.

Melzer said parents may be enrolling in health plans through the exchange without realizing that Children’s is not included in the plan’s network.

“The notion that a major insurance plan is going to exclude us from their network is truly precedent-setting and represents a new level of degradation in children’s access to care,” Melzer said.

Of the seven insurers offering plans in King County, only two – Group Health Cooperative and Community Health Plan of Washington – are offering plans through the exchange that include Seattle Children’s in their network.

The five in King County that do not include Children’s in their network are Premera Blue Cross, LifeWise Health Plan of Washington (a subsidiary of Premera), BridgeSpan (a subsidiary of Regence Blue Shield), Molina Healthcare and Coordinated Care.

Kaiser Foundation Health Plan of Washington, which is offering plans only in Clark and Cowlitz counties, also does not include Seattle Children’s in its network.

Children’s is asking that the OIC reverse its decision to allow Molina and Coordinated Care to sell plans on the exchange as long they do not include the hospital in their networks.

OIC spokeswoman Stephanie Marquis says the OIC takes concerns about access to care seriously. “We are reviewing Children’s petition to see what lies at the heart of their concerns and will see how it gets resolved through the legal process,” she said.

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Insurers’ Letters Spur Washington State Consumer Alert

Amy Snow Landa, Seattle Times — Fri, 20 Sep 2013 12:00:28 +0000

This story was produced in partnership with

The Washington state insurance commissioner issued a consumer alert Thursday advising state residents who buy their own health insurance to know their options when choosing their next health plan.

The commissioner’s office issued the alert in response to dozens of phone calls and emails from consumers upset by letters from insurance carriers informing them their current health plan would be discontinued at the end of the year.

Insurance carriers are replacing their current individual health plans with new insurance products that include the essential health benefits and limits on cost-sharing required under the federal Affordable Care Act.

All of the carriers have sent customers a 90-day notice that their current plan will be discontinued. The letters also suggest a specific health plan –- one of the insurer’s other products –- as a replacement.

The letters sent by Regence Blue Shield and Group Health Cooperative also state that consumers can explore additional health-plan options available from other carriers and through the state’s new health-insurance exchange, Washington Healthplanfinder.

But the letters sent by Premera Blue Cross and its subsidiary LifeWise Health Plan of Washington do not mention these other options.

“Companies are required to give you notice if they’re replacing your plan,” Insurance Commissioner Mike Kreidler said in a statement. “But, unfortunately, they may not include all of your options — including your right to pick a new plan from a different company, or buy through the new exchange, WAhealthplanfinder.org.”

The insurance commissioner’s office is concerned that this omission may mislead consumers, said spokesperson Stephanie Marquis.

The regulator had advised all of the carriers that they include information about Washington Healthplanfinder in their discontinuation letters. Only Premera and LifeWise did not do so, Marquis said.

The OIC offers a map of on its website.

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Attacking Raccoons Used In Washington State Insurance Ads

Amy Snow Landa, Seattle Times — Wed, 18 Sep 2013 11:35:07 +0000

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The Washington Health Benefit Exchange has begun airing television commercials as part of a stepped-up campaign to promote the state’s online insurance marketplace, which opens for enrollment Oct. 1.

The convey the sobering message that going without health insurance is “playing with chance” and could lead to a bad outcome.

One of the spots shows a snowboarder hurtling down a mountain and losing control, landing with a bone-crunching thud.

The narrator tells viewers the state’s exchange, called Washington Healthplanfinder, “offers new low-cost and free plans,” warning that “without one, you could go bust.”

The other ad features a snarling raccoon leaping out of a garbage can, poised to attack a woman in her own backyard.

“Washington Healthplanfinder offers financial help on new plans,” says the narrator, warning that “without one, it could bite you.”

These ads are darker than the sunnier, more upbeat ads that have aired in states such as Colorado and

target=”_blank”>Oregon

Colorado’s ads focus on the idea that consumers “win” by enrolling in coverage through the state’s health exchange. Ordinary people are shown celebrating their victory as if they have just won a or a high-stakes .

In contrast, Washington’s ad campaign is more about avoiding disaster.

The TV spots are meant to grab people’s attention, says Michael Marchand, communications director for the agency that operates Washington’s exchange. The goal is to motivate Washington residents – especially the uninsured – to find out how they can get coverage through .

Marchand says the two ads resonated with focus groups. A significant number of people identified with the snowboarder and said they worried about engaging in activities that could lead to serious injury, especially if they are uninsured.

The ad featuring the scary raccoon also struck a chord, according to Marchand.

“I was really surprised how many people had had encounters with raccoons,” he said.

The TV spots are part of a broader advertising and promotion campaign that includes radio spots and online ads that started running in August.

The goal is to enroll 130,000 people in health-care coverage through the exchange by the end of this year and 280,000 in 2014.

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Washington State Call Center Logs 900 Calls On 1st Day

Amy Snow Landa, Seattle Times — Fri, 06 Sep 2013 10:00:18 +0000

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The phones are already busy at the Washington State Exchange call center where customer service representatives are fielding hundreds of questions about the state’s new health insurance exchange, slated to open for enrollment Oct. 1.

The call center, located in Spokane, opened on Tuesday and took 900 calls that day.

Richard Onizuka, CEO of the Washington Health Benefit Exchange, says the first call came in before 7:30 a.m., the official start time.

There were more than 100 calls within the first hour, he told the board of the exchange at its .

Onizuka and other members of the exchange staff were on-hand at the call center for its opening.

Onizuka said there were about 60 customer service representatives working Tuesday, including about half a dozen Spanish speakers. There are about 80 customer service representatives altogether.

Most of the calls were about eligibility and enrollment. There were seven calls in Spanish, Onizuka said.

Representatives were able to help callers use the cost-estimate calculator available at .

“A lot of the folks who were calling in seemed to be very pleasantly surprised at what they would be able to qualify for in terms of financial assistance,” Onizuka said.

The number of calls declined to about 650 the second day, according to Exchange spokesman Michael Marchand.

The call center is open weekdays from 7:30 a.m. to 8 p.m. The toll-free number is 1-855-WAFINDER (1-855-923-4633). Washington residents can also email questions to customersupport@wahbexchange.org.

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Washington State Panel OKs 7 Insurers For Exchange

Amy Snow Landa, Seattle Times — Thu, 05 Sep 2013 12:48:53 +0000

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In the end, it was a calm affair.

The Washington Health Benefit Exchange Board met in a special session Wednesday afternoon to vote on the certification of health plans for the state’s new online health insurance marketplace in 2014.

In less than an hour, the board voted unanimously to approve the health plans of seven insurers: Premera Blue Cross, LifeWise Health Plan of Washington, BridgeSpan, Group Health Cooperative, Kaiser Foundation Health Plan of the Northwest and two Medicaid insurers, Community Health Plan of Washington and Molina Healthcare of Washington.

The board’s certification is the final step in the process before the state can load data into a federal database about the health plans that will be sold through the state’s health-insurance exchange, called Washington Healthplanfinder.

The board had twice put off voting on certification, which was originally scheduled for Aug. 21, then rescheduled for Aug. 29, and rescheduled a second time for Wednesday.

Board members said during previous meetings that they were concerned that the four insurers approved by Insurance Commissioner Kreidler on Aug. 1 did not provide adequate competition and choice. The board voted to delay certification to allow rejected insurers to appeal.

Kreidler announced Aug. 30 he had reached settlements with Community Health Plan of Washington and Kaiser Foundation Health Plan of the Northwest. He announced Wednesday morning, just before the Exchange Board meeting, that he also had settled with Molina. He approved the plans of all three insurers for the exchange.

As a result of today’s vote, the board has certified 35 health plans offered by seven insurers for the exchange. The federal Office of Personnel Management is expected to certify an additional eight multi-state health plans, bringing the total number to 43.

But it’s not over yet.

Another rejected insurer, Coordinated Care, is still trying to get the commissioner’s approval. An administrative-law judge issued a ruling Tuesday night advising Coordinated Care and the commissioner’s office to work together to get the insurer through the process.

It’s unclear how that will turn out. But the Exchange Board has agreed to meet Thursday afternoon or Friday morning to vote on certifying Coordinated Care’s health plans if the insurer can gain the commissioner’s approval by then.

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Washington State Launches Ad Blitz Promoting Health Exchange

Amy Snow Landa, Seattle Times — Mon, 26 Aug 2013 18:53:49 +0000

With five weeks left until Washington state launches its online health-insurance exchange, many residents may have heard little about the program designed to offer coverage to the uninsured.

That’s begun to change.

The state began rolling out the first phase of its ad campaign last week to let the public know about the exchange, a central part of the federal Affordable Care Act, also known as Obamacare.

The campaign, aimed at signing up , began airing radio spots last Tuesday and online ads last Wednesday. The aim is to sign up 130,000 uninsured people by the end of this year and 280,000 people in 2014 to buy coverage in the online marketplace, called Washington Healthplanfinder.

The campaign is drawing from $26.3 million in federal funds the state has received to support marketing and outreach efforts.

The exchange was created under provisions of the law that delegated the establishment of such marketplaces to states that chose to build them. Beginning Oct. 1, Washington residents will be able to go to the Healthplanfinder website to compare 31 health plans, apply for subsidies to pay the premiums and enroll in coverage to take effect Jan. 1.

State officials hope the ad campaign, combined with an array of outreach and marketing efforts, will drive a large number of Washingtonians to the website, and not just those who are uninsured.

“Our goal is to have the more than 6½ million residents of this state go to Healthplanfinder to see what opportunities are there for them or someone they know,” said Michael Marchand, communications director of the health-benefit-exchange agency.

The hope is that people will go to the website and pass on what they learn to friends and family members who do not.

“Everyone knows someone who can take advantage of the opportunities the Healthplanfinder will provide,” Marchand said.

Marchand’s agency is working with a variety of community groups and organizations to spread the word about the Healthplanfinder website.

The exchange agency has been posting regular updates on its Facebook page (

) and through its Twitter feed (@WAplanfinder).

“We’re also looking at leveraging YouTube for certain elements of the campaign,” Marchand said.

State officials recognize they face a big challenge in trying to persuade people who are uninsured to sign up for coverage.

“We recognize they’re a very hard-to-reach population,” says Marchand. Many of them have had little experience with health insurance and may be unfamiliar with how it works. Others have tried to get coverage in the past, but without success.

Market research found that many of Washington’s uninsured are skeptical about their chances of finding a health plan that is affordable, said David Smith, a partner at GMMB, a strategic communications firm with offices in Seattle and Washington, D.C., which is coordinating the advertising and marketing campaign.

To address these doubts, the ads emphasize that Healthplanfinder offers the uninsured a new opportunity to enroll in affordable coverage and that financial assistance is available.

“There’s a first time for everything,” one radio spot tells listeners. “Like this October, when you might qualify for low-cost or even free health insurance for the first time.”

The ad campaign is starting small but will kick into high gear by mid- to late September.

In addition to radio and online ads, print ads will appear the week after Labor Day in community-based publications, including African-American newspapers and foreign-language publications. Ads will be translated into Chinese, Vietnamese, Korean, Spanish and Russian.

Television commercials also won’t hit the airwaves until after Labor Day, and possibly not until mid-September, Marchand said.

That puts Washington behind states such as Colorado and Oregon, which have been running television commercials about their programs for several weeks.

But there are strategic reasons to delay, according to Marchand.

State officials do not want to launch an ad blitz before there are resources in place to answer people’s questions about Healthplanfinder, which the ads are expected to stimulate.

“Other states went up with ads early, but there was really nothing for them to share other than the message ‘this is coming soon,’ and that isn’t enough,” Marchand said.

The state is setting up a toll-free hotline and a call center in Spokane scheduled to go live Sept. 3. Television commercials will start airing sometime after that.

Washington officials also don’t want to stimulate people’s interest in Healthplanfinder too far in advance of when they can actually sign up for coverage.

“Washington is certainly not alone in deciding not to do a big advertising push until there is a functional website, a call center, and real options that people can act on to start purchasing coverage,” said Caroline Pearson, vice president at Avalere Health, a Washington, D.C., consulting firm that is tracking marketing and outreach efforts across the country.

The $26.3 million Washington has in federal funds for advertising and outreach through 2014 is “a robust amount,” Pearson said.

The amount includes nearly $19 million awarded to GMMB, most of which is expected to be spent on buying ad placements, Marchand said.

This story is part of a collaboration that includes and Kaiser Health News.

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