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Idaho health insurance exchange

Your Health Idaho transitioning to state-run platform

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Open enrollment for 2015 is now just over two months away – it starts on November 15 – and Your Health Idaho is gearing up for an excellent round two.  Although HHS ran the technical aspect of the exchange in 2014, the state-run portion of the partnership exchange was very active in getting as many people as possible educated about the ACA and enrolled in coverage.

Idaho is transitioning to its own exchange platform, and will be a fully state-run exchange in time for the 2015 open enrollment period. Your Health Idaho announced in February the selection of two vendors to build its technological platform. GetInsured will handle design, implementation and testing of the platform. Accenture will provide day-to-day project management.

People who enrolled through Healthcare.gov for 2014 coverage will be able to renew their plans for 2015, and Your Health Idaho is working with HHS and the state’s carriers to make the process as seamless as possible.  Although the exchange will no longer be using Healthcare.gov as of November 15, current enrollees will not have to start from scratch with the new system.  The exchange is working to get enrollee data transferred over from Healthcare.gov, and the carriers in the state are committed to making this a smooth transition and making sure that people are able to keep their plans and subsidies (adjusted for 2015 if necessary based on the local benchmark plans).  The exchange is asking current enrollees to participate in the renewal process though, and they already have a section on their website devoted to renewals, with a page of instructions specifically for people who enrolled in 2014 and received a tax credit.

The state of Idaho will be reviewing and approving 2015 rates during September, and rates will be available on Your Health Idaho starting in early October.  At that point, consumers will be able to browse anonymously and see 2015 rates along with estimated subsidy amounts.  This should give 2015 enrollees a chance to compare plans and check on provider networks before the actual open enrollment rush begins in November.

Before November 15, people who get married or divorced, change jobs, have a child or experience another qualifying event may be eligible for a special enrollment period. Enrollment for Medicaid and the Children’s Health Insurance Program (CHIP) continues throughout the year. Native Americans can sign up through Your Health Idaho anytime during the year. To check if you qualify to buy insurance before Nov. 15, call 1-855-YH-Idaho (1-855-944-3246). In 2014, individuals who don’t have health insurance that provides “minimum essential coverage” may have to pay a penalty: $95 per uninsured adult or one percent of income, whichever is greater.

More than 76,000 Idahoans signed up for health insurance during the first enrollment period. That’s 36,000 more than the target set by the federal government, and in a state of only 1.7 million people, the per-capita enrollment ranks Idaho third in the nation for plans purchased during the first open enrollment period.

Among Idaho residents selecting a QHP, 92 percent qualified for financial assistance, compared to 85 percent nationally. Only Mississippi and Wyoming had higher rates of individuals eligible for assistance. A report released in June by the U.S. Department of Health and Human Services showed the average monthly premium, after tax credits, for Idaho consumers was $68. Fifty percent of those Idaho enrollees who qualified for subsidies pay $50 or less per month after subsidies.

During the 2014 open enrollment period, fifteen percent of Idaho residents selected a bronze plan (20 percent nationally), 72 percent selected a silver plan (65 percent nationally), 10 percent selected a gold plan (9 percent nationally), 3 percent selected a platinum plan (5 percent nationally) and 1 percent selected a catastrophic plan (2 percent nationally). Twenty-seven percent of Idaho enrollees were between the ages of 18 and 34.

Republican Gov. Butch Otter announced in December 2012 that Idaho would implement a state-run health insurance exchange, and HHS gave conditional approval of the state’s plan in early January 2013. The state-run option was resisted by both the governor and many Republican legislators. Like those in other “red” states, Idaho leaders hoped the U.S. Supreme Court would find the Affordable Care Act (ACA) unconstitutional. However, after the Court upheld most elements of the ACA and a state task force in October 2012 strongly recommended a state-run exchange, Otter began leaning toward that option as preferable to a federally run exchange. After Otter’s announcement in December, legislators began considering legislation, and both chambers passed bills authorizing a state-run in exchange in the first quarter of 2013. However, that left scant time to set up the exchange. For the first open enrollment period, Idaho used the federal site for enrollment, but will be switching to an entirely state-run platform by November 2014.

Your Health Idaho touts a low assessment fee as one of biggest consumer benefits to running its own exchange. For both 2014 and 2015 policies, Your Health Idaho is charging an assessment fee of 1.5 percent of premium cost. On the federal marketplace, the fee is 3.5 percent.

A new insurer has been approved by the Idaho Department of Insurance: Mountain Health CO-OP. Mountain Health hopes to sell policies through Your Health Idaho when 2015 open enrollment begins. Four plans sold individual policies on Your Health Idaho for 2014: Blue Cross of Idaho, BridgeSpan, PacificSource, and Select Health.

Your Health Idaho created a strong partnership with agents and brokers in the state, and 50 percent of the exchange’s 2014 enrollments were facilitated by agents and brokers.  Your Health Idaho refers to agents and brokers as a “backbone” of the exchange, and credits the partnership with them as the main factor that drove enrollment in 2014.  Heading into the second open enrollment period, the exchange still has a very strong relationship with the state’s agents and brokers, and is looking forward to having the entire process in the hands of Idahoans.

Idaho is the only state that opted to build its own marketplace, but decided against expanding eligibility for its Medicaid program. According to the Kaiser Family Foundation, the decision means about 55,000 low-income, non-elderly adults will fall into the coverage gap — meaning they don’t qualify for Medicaid or for subsidies to help them purchase private coverage. While a Medicaid workgroup appointed by Gov. Otter supports Medicaid expansion, there is little to no support in the state legislature.  The issue of Medicaid expansion is expected to come before the legislature again in the 2015 session.

Idaho health insurance exchange links

Your Health Idaho
855-YHIdaho (855-944-3246)

Idaho Health Insurance Exchange
This site provides information about exchange planning and start-up; a consumer-facing site is under development.

State Exchange Profile: Idaho
The Henry J. Kaiser Family Foundation overview of Idaho’s progress toward creating a state health insurance exchange.

Idaho Department of Insurance
Answers questions about insurance bought on the individual market and insurance provided by an employer who only does business in Idaho.
(208) 334-4250 / toll-free (800) 721-3272