Colorado’s Health Exchange Board is Unbalanced?

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4min 51sec

The new Colorado Health Benefit Exchange board’s goal is to increase competition and drive down the cost of insurance. But even as it started work yesterday, consumer advocates say the insurance industry has too much say. CPR Health Reporter Eric Whitney has more.

CPR Health Reporter Eric Whitney: You don't have to tell Richard Betts that health coverage is a major headache for small businesses. Betts runs an accounting firm with about 600 small business clients.

ASAP Accounting and Payroll President Richard Betts: They are the HR dept, the janitor, the cashier, and so many of them have just pushed health care aside and not dealt with the issue.

Whitney: That means lots of small business employees go without coverage, Betts says, and that's bad for everyone. Because when somebody without insurance has to go to the emergency room and can't pay their bill, the cost is passed on to everybody else and health care just keeps getting more expensive.

Betts wants to help fix that, so he threw his hat in the ring and was appointed to Colorado's brand new health insurance exchange board.

Betts: The exchange is going to be, hopefully, if we structure it correctly, where they can go get transparent information, be able to evaluate different programs, and easily have their employees enrolled in the programs through the exchange website, so we hopefully can take some of the administrative aspects off of their shoulders.

Whitney: Health insurance exchanges, set up at the state level, are a key part of the federal Affordable Care Act passed last year. Colorado legislators passed a law this spring to create an exchange here. That meant Elected Democrats and Republicans appointed a board, which met for the first time yesterday.

SOUND: At exchange board meeting, establish and fade under.

Whitney: More than a hundred people came to watch the exchange board get started, many of them from consumer interest groups, and many of those groups say the board appears to be dominated by the health insurance industry. Lorez Meinhold disagrees.

Lorez Meinhold, Deputy Policy Director, Governor’s Office of Policy and Initiatives:I think it's an unfair characterization to say that they're skewed one way or the other.

Whitney: Meinhold is one of Governor Hickenlooper’s health care advisors. His office picked the majority of board members. Meinhold says they were chosen to meet a very specific list of requirements in Colorado's exchange law.

Meinhold:You need individuals to participate, but you need insurers to participate, they actually have to offer a product. If there's no products to be offered, there's no exchange, and so this is about finding the right balance, the right mix of having those different expertise and skill sets to make this successful.

Whitney: But where Meinhold sees balance, consumer advocates see domination by the insurance industry. The board has nine voting members. Three are C-E-Os of health insurance companies. Another runs a company that administers mental health benefits, and one is V-P of a software company serving the health care industry, including insurance companies. Consumer advocates say that's an industry majority.
But the software executive, Eric Grossman, disagrees.

Eric Grossman, vice president of strategy and governmental affairs, TriZetto: we trust the state to create a balanced board, and we're committed to impartiality, and we don't have any intent of going after any state health insurance exchange contracts in this state or any state.

Whitney: That's not good enough for Danny Katz, director of COPIRG, the Colorado Public Interest Research Group. He says Grossman, specifically, needs to resign, because of an article the executive wrote late last year.

COPIRG Director Danny Katz: He wrote in a publication that one part of the exchange that would be bad is the competitive market piece, because for insurance companies in particular, it would force them to reduce costs and increase efficiencies.

Whitney: Katz says that's a problem, because reducing costs and increasing efficiences are primary goals of exchanges. Grossman's article, he says, shows bias against exchanges. Grossman says the quote is being taken out of context. He says it's true that increased compeittion will be a challenge for insurance companies, but that he and his company are committed to creating an exchange that's good for Colorado consumers.
For his part, small business advocate and exchange board member Richard Betts says he's giving Grossman the benefit of the doubt -- but he’s glad consumer groups are paying such close attention.

Betts: They, the members that are representing insurance companies that are going to benefit by the sale of insurance, they need to be like Ceasar's wives, they need to be above reproach. They need to recuse themselves of any votes or any policy decisions that could somehow affect their industry.

Whitney: But Betts says if those members have to recuse themselves too often, then maybe Colorado will need to rethink the makeup of the board. Right now though, the body has more mundane tasks ahead of it. Colorado's health insurance exchange board next meets in two weeks, when they're expected to elect a chairperson and come up with a work plan, with an eye toward having a fully functioning excange in 2014.

[Photo: Eric Whitney]