Something to Talk About: Soliciting Stakeholder Input on Exchanges

As states move forward with Exchange planning, key stakeholder groups are providing input on Exchange design, governance and functions. This input on specific policy decisions can help planners generate new ideas, create participant buy-in, and add transparency to ACA implementation. At State Refor(u)m, we’re following what states are doing to solicit input from small businesses, industry experts, consumer advocates, providers, and other Exchange stakeholders.
In an effort to make Exchange planning as inclusive as possible, many states are holding statewide forums that help to identify which organizations and individuals wish to be involved on a deeper level. In West Virginia, the Offices of the Insurance Commissioner held severalstakeholder sessions with the intention of creating “community of interest” subgroups focused on areas such as Exchange operations, budget and finance, and access and outreach. Other states are soliciting stakeholder input through existing health policy advisory groups. Ohio’s Health Benefit Exchange Task Force has its roots in a previous health care council, and consists of payers, providers and other stakeholder constituencies.
In order to get the best information from stakeholders, Exchange planners need to ask the right questions. In the District of Columbia, where stakeholder meetings are being held this summer, officials developed an engagement plan that lays out key questions regarding Exchange goals, governance, program integration and more. Similarly, Maryland identified a list of issues and questions for public comment at the outset of its outreach efforts. Here are some examples from Maryland’s list of key issues:

• Functions of an Exchange: Which functions beyond the minimum clearinghouse functions articulated in the federal law, if any, should the Exchange perform?
• Governance structure and navigator function: Which governance structure would best accomplish the goals of the Exchange? Where should the navigator function be located?
• Selection and take-up: What strategies and policies should the state adopt to encourage a high take-up rate by individuals to purchase health insurance, in order to prevent the Exchange from becoming a high-risk pool?
• Phasing-in: Should the state phase in any other Exchange or insurance market reforms prior to 2014 in order to gradually transition to the new rules?
• Self-sustaining financing: How should the Exchange’s operations be financed after federal financial support ends on December 31, 2014?

Several states are also using surveys to gather early feedback from stakeholders and focus future discussions. The Nebraska Department of Insurance, which has held several stakeholder meetings, also created a web survey that asks people to weigh-in on the Exchange’s business model, small and individual market requirements, and relationship with Medicaid, among other topics. People who attended West Virginia’s stakeholder sessions also received a survey; results of the survey are included in a stakeholder response summary.
What is your state doing to involve stakeholders in Exchange development? Share your state’s engagement plan, slide show presentations and other work by choosing your state and the milestone “Solicit stakeholder input on Exchange design” under “Be Strategic with Insurance Exchange.”