CEO: Health exchange just a start

New system ‘has a lot of fashioning to do,' president of health plan says

Gov. John Hickenlooper’s signature on a bill establishing a health insurance exchange in Colorado marks the beginning of a process, not the end, the head of Rocky Mountain Health Plans said Thursday.

The health exchange approved by a bipartisan majority in the Legislature “has a lot of fashioning to do,” said Steve ErkenBrack, who added he is willing to sit on the nine-member board that will construct the exchange.

Among the hundreds of issues the exchange will tackle are how small businesses will be rated, even what constitutes a small business, how to reconcile regional differences in the cost of health care and so on, ErkenBrack said.

There also is the matter of protecting regional interests, said ErkenBrack and Diane Schwenke, president and chief executive officer of the Grand Junction Area Chamber of Commerce.

“We would like to see western Colorado represented” on the exchange board, Schwenke said. “We have a unique health care system in Mesa County, and we have to be vigilant in protecting it. The insurance and health care climate is very different than it is on the Front Range or anywhere else in Colorado.”

Rocky Mountain Health Plans is part of the health care system in Mesa County that has drawn plaudits from across the country and is being studied by Nobel laureate Elinor Ostrom for lessons that can be learned elsewhere.

ErkenBrack said he has been approached by members of the business community and is willing to serve on the board, “but it’s not something I’m expecting because I run a health plan.”

Another matter the board will have to decide is whether individuals will be rated differently than small businesses and even whether small businesses are companies with 100 or fewer employees, as defined by federal law, or 50 or fewer, as they are defined under Colorado law, ErkenBrack said.

That’s a significant issue because companies with 50 or fewer employees make up 90 percent of the chamber’s membership base, Schwenke said.

Regional issues run deeper than east versus west, ErkenBrack said.

“The cost of health care in Delta is a lot less than it is in Aspen,” and the board will have to decide how to handle rates in those places, as well as reconcile other regional differences.

“There are dozens of issues and good arguments on both sides” as the board decides how the exchange will work with insurers to provide choice to consumers and businesses, ErkenBrack said.

Time already is an element because Secretary of Health and Human Services Kathleen Sebelius will decide by Jan. 1, 2013, whether to certify states’ exchanges.

Those exchanges will have to be operational as of Jan. 1, 2014, under the new federal health care law.


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