If you care about public policy in Rhode Island, there’s one article you have to read this week: “36 Hours Behind Rhode Island’s Health Exchange,” a new Governing magazine story by staff writer Dylan Scott.
The centerpiece of President Obama’s Affordable Care Act are the new health-insurance exchanges, online marketplaces where residents will be able to comparison shop for coverage and access federal subsidies to help them pay premiums. It’s modeled on the Massachusetts Health Connector, which was set up in 2006 by the Romney administration.
Rhode Island is one of 17 states that are setting up their own exchanges as the law’s architects intended, and the state has $65 million to get it up and running. Now the staff is scrambling to prepare for the Oct. 1 start of enrollment on the exchanges, as Scott explains:
Everybody around here, most of whom have spent some time in the private sector, emphasizes how creating the exchange, which centers on launching a complex yet functional and usable website, is more like working at a commercial start-up. This isn’t some entitlement program with automatic eligibility and a strict set of benefits. Dharma Yechuri, a private consultant who came from Blue Cross/Blue Shield in North Carolina, explains that the whole enterprise boils down to getting a segment of state government to think like “a product-centered business.”
Ian Lang, the exchange’s director for marketing and communications, puts it another way: “We’re asking people to change their buying habits. We’re asking them to buy this product.” In many ways, that’s a totally new role for government.
As we discussed when exchange chief Christine Ferguson appeared on Newsmakers recently, it’s an open question whether Rhode Island was right to create its own exchange rather than, say, try to join the Massachusetts Connector or create a regional grouping. (RIPEC looked at some of the questions in this study.) But now that the path has been chosen, it matters whether the people in charge get it right, particularly since health care is one of the few bright spots left in the Rhode Island economy.