OP-ED: Health Insurance Exchange Needs a Passionate and Visionary CEO

As Connecticut prepares to launch its Health Insurance Exchange (HIX) as part of health care reform, those of us that live and work here must work together to ensure our needs as consumers are met.  It is concerning that the Board of the HIX is composed of several recent insurance company executives and almost no consumers.  The Board is currently in the midst of hiring the CEO and the other key management positions.  If as citizens and consumers, we fail to make our voices heard and advocate for a CEO that is consumer-oriented; the Board will most likely either hire a mid-level insurance company executive or a bureaucrat as the CEO.  As consumers, we would then not have a reform oriented CEO that would be a passionate visionary in helping create an effective HIX that will make real health insurance plan choices available in Connecticut for Individuals and Small Businesses. 

Since the HIX is a quasi-government start-up small business enterprise, basically a health insurance brokerage firm, it is extremely important that the person have experience in growing a small business from 5-to-50 employees in under a year; and that they are very familiar with the inner-workings of the State Capitol.  If the CEO is not a passionate visionary that understands the significant positive impact the HIX will can have for Connecticut’s citizens, it is highly unlikely that the person will be willing to work the typical 60 plus hours a week that a small business owner works when growing a business; or, find ways to overcome governmental hurdles that will be an inherent part of launching the HIX.  The CEO should be knowledgeable and experienced with Connecticut’s current health insurance marketplace for Individuals and Small Businesses; including the differences in mandates.  For example, maternity, normal childbirth, is not a covered or mandated benefit in Individual health insurance plans; but small business health plans do mandate coverage for the benefit.  A CEO that is consumer-oriented would most likely advocate for covering maternity in Individual health plans; instead of leaving Medicaid to cover all pregnancies in the Individual marketplace.   

If the citizens of Connecticut do not advocate for a passionate consumer-oriented reform minded visionary as the CEO of the HIX, it is likely that we will be left behind, again.  As an example of the need to advocate today; at a recent HIX Board meeting, a consultant with experience in launching the Massachusetts Health Exchange several years ago stated that Connecticut should look to their experience and avoid the mistakes they made in launching their exchange and significantly underestimating how many people would turn to the exchange for their health benefits.  One of our HIX Board members stated that the consultant’s numbers of possible enrollees in Connecticut’s HIX were too optimistic at ~100,000; and that even 40,000 enrollees would be an overly optimistic number for January 1, 2014.  The comment was that there is no significant cost savings to consumers; and that the Federal Premium Subsidies for Individuals and Federal Tax Credits for Small Businesses only available through the HIX would not be significant enough for consumers or Small Business owners to make the effort to purchase their health insurance plans through the exchange.

Tony Pinto