Health-insurance-exchange details coming into focus

By Richard Asinof
Contributing Writer
In the next few weeks, Gov. Lincoln D. Chafee is expected to issue an executive order creating a Rhode Island health-insurance-benefits exchange, a process recommended by the executive committee of the R.I. Healthcare Reform Commission on July 18 in a unanimous voice vote. More

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Health Matters

Health-insurance-exchange details coming into focus

PBN PHOTO/NATALJA KENT
EXCHANGE OF IDEAS: Deborah Faulkner, the project director of the state's efforts to design a health exchange, says Massachusetts is ahead of the curve nationally.
By Richard Asinof
Contributing Writer
Posted 8/8/11

In the next few weeks, Gov. Lincoln D. Chafee is expected to issue an executive order creating a Rhode Island health-insurance-benefits exchange, a process recommended by the executive committee of the R.I. Healthcare Reform Commission on July 18 in a unanimous voice vote.

The move is an attempt to overcome the failure of the General Assembly to enact enabling legislation during its last session – and, more importantly, meet the funding deadline of Sept. 30 set by the federal government to be eligible for the next installment of financial support for establishing such exchanges. The latter is said to be worth up to $15 million, according to Lt. Gov. Elizabeth H. Roberts, who chairs the executive committee.

Once it is established by executive order, Roberts said, it’s possible the exchange could be converted into a quasi-public authority. But first, “we don’t want to miss the funding deadlines,” Roberts said.

The basic goal of the benefits exchange is to support the mandate under the federal health care reform law that everyone has health insurance. There are about 140,000 Rhode Island residents who are currently uninsured. “You need a place for them to buy it, and you need subsidies for those who cannot afford it,” explained Deborah Faulkner, of the Faulkner Consulting Group, who is the project director of the state’s efforts to design the mechanics of the exchange, working under a federal grant to the state Office of the Health Insurance Commissioner.

One of the principal tasks of the benefits exchange will be to determine eligibility: whether a person may be eligible for Medicaid coverage, or subsidies, and if not, how to buy coverage. All that will happen when individuals enter personal information, such as social security number, earnings, family structure and the like. “It’s a pretty complex thing that the exchange is being asked to do – determine eligibility for everyone,” Faulkner said.

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