Excerpt
Television commercials have already run suggesting that buying health coverage through the state’s new insurance market, Connect for Health Colorado, will feel like winning the World Series.
The market’s employees are traveling the state to explain how it will work, often in electric yellow T-shirts with the message, “Got Insurance?” In the coming weeks, 400 guides will be trained to help the uninsured sign up for coverage, with some targeting groups like Hispanics, gay and lesbian citizens, and even truckers.
This is Colorado, five months before the central provisions of President Obama’s health care law take effect: a hive of preparation, with a homegrown insurance market working closely with state agencies and lawmakers to help ensure the law’s success. Gov. John W. Hickenlooper, a Democrat, is a firm supporter, and the state legislature, controlled by Democrats, has not thrown up any obstacles.
When the legislature voted to allow a state-based insurance market in 2011, Republicans controlled the House of Representatives, but many supported the bill, contending that it would give Colorado more control over how the health care law played out here. This spring, state lawmakers voted along party lines to approve an expansion of Medicaid, which is encouraged but not required under the law.
The law does have opponents in Colorado, but they can do little to stop the Democrats from carrying it out. In February, Republicans even helped kill a bill that would have repealed the law allowing the insurance market.
“There’s politics everywhere these days,” Mr. Hickenlooper said in an interview, “but for the most part, we’ve really been focused on how to do this right, and trying to make sure that people have affordable health care.”
Connect for Health has received about $180 million in federal money to be up and running by Oct. 1 and to cover the first year’s operating costs.
Much of the work involves building the Web portal through which people who do not get insurance through their job can buy coverage. Colorado residents will be able to shop for insurance plans and compare them on www.connectforhealthco.com, and determine whether they qualify for federal subsidies to help with the cost.
The portal has to be able to exchange information in real time with insurance companies, state agencies and the federal government, which is building a “data hub” through which it can verify income and citizenship.
"Missouri Citizens Face Obstacles to Coverage" by ROBERT PEAR New York Times 8/2/2013
Excerpt
Looking for the new health insurance marketplace, set to open in this state in two months, is like searching for a unicorn.
The marketplace, or exchange, being established by the federal government under President Obama’s health care law has no visible presence here, no local office, no official voice in the state and no board of local advisers. It is being run like a covert operation, with no marketing or detailed information about its products or their prices.
While states like Colorado, Connecticut and California race to offer subsidized insurance to their citizens, Missouri stands out among the states that have put up significant obstacles. It has refused to create an insurance exchange, leaving the job to the federal government. It has forbidden state and local government officials to cooperate with the federal exchange.
It has required insurance counselors to get state licenses before they can help consumers navigate the new insurance market. And, like many states, it has refused to expand Medicaid.
“It’s like running an obstacle course every day of the week, but the course changes from day to day,” said Herb B. Kuhn, president of the Missouri Hospital Association, a strong advocate of expanded coverage.
State Senator Rob Schaaf, the Republican author of a 2012 ballot measure that prevented the state from setting up its own insurance exchange, said: “We can’t afford everything we do now, let alone provide free medical care to able-bodied adults. I have a philosophical problem with doing that, and I’m also worried about our country’s financial situation.”
Over 850,000 Missouri residents, including low-income people in St. Louis and Kansas City, family farmers and small-business employees, are uninsured. Many could qualify for coverage through the exchange, which encourages competition and offers subsidies to reduce costs.
Kenneth L. Schmidt, an insurance broker in St. Louis who intends to sell insurance products offered on the exchange, said: “We have not seen any evidence of the federal exchange — how it will be run, how it will be structured in Missouri. Will it be run from Jefferson City? Will it be run from Washington? Who will watch over it? No clue.”
David R. Griggs, who owns a carpet store with 15 employees in Columbia, Mo., said he was hungry for information about the exchange. But, he said, “I have not seen or heard a word about it.”
Kat Cunningham of Columbia, the president of Moresource, a firm that handles payroll and benefits for more than 600 employers, said she had been deluged with questions from clients and was struggling to provide guidance.
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