By Katie Kerwin McCrimmon
Colorado health exchange managers spent $10 million over the past year on a statewide assistance network that generated about 8,000 sign-ups for private health insurance.
Board critics pressed managers on the wisdom and sustainability of spending about $1,250 per customer for the face-to-face help centers.
Altogether, health guides at 150 locations around the state signed up a total of 46,000 people for new health coverage. All but 8,000 of those people qualified for public health programs including Medicaid and CHP+, a program for children.
“It’s high on the Medicaid side and low on the exchange side,” conceded Adela Flores-Brennan, the exchange’s director of community assistance programs.
Connect for Health Colorado’s finance committee members met on Thursday in advance of a meeting Monday when they must vote on a budget for the next fiscal year. They also will vote on whether to charge fees of about $13 million on Coloradans with health insurance, even those who don’t buy through the exchange.
In addition to reviewing costs for the assistance network, managers revised their total enrollments down. They are now estimating that at least 30 percent of people who signed up for health insurance in 2014 will drop out, won’t pay or will get insurance through another source such as a new employer.
In their most recent numbers, exchange officials had reported that about 127,000 people signed up for private health insurance through the exchange for this year.
A new financial projection now shows that exchange officials expect only about 85,589 customers to keep their insurance.
Exchange CEO Patty Fontneau said other states are expecting to lose clients at an even higher rate.
“Some other states are assuming 35 to 40 percent (attrition),” Fontneau said.
“It’s a good lesson,” said Connect for Health Chief Financial Officer Cammie Blais.
“We will have other unforeseen impacts. We need to be cautious,” she said.
The limited private health sign-ups through the assistance network triggered concerns from board members.
“It’s clear (the assistance network) is a very good thing and doing really good work. Ideally, we would want to fund it at an even higher level,” said finance committee member Ellen Daehnick. “But we’re not in an environment of unlimited resources.
“We’re coming up on a period when we have to pay our own bills,” said Daehnick.
Board members Dr. Mike Fallon and Richard Betts seconded Daehnick’s concerns about spending so much for relatively few sign-ups. But Betts said the spending on the assistance network makes more financial sense if the exchange is committed to subsidizing Medicaid and CHP+ sign-ups.
In that case, the spending adds up to about $217 per person, Betts said.
Shepard Nevel, vice-president of policy, evaluation and communication for the Colorado Health Foundation, attended the finance committee meeting and announced that the foundation is donating $2.5 million toward next year’s budget for the assistance network. That brings the foundation’s total support for the assistance network to about $4.5 million.
He said the exchange is doing “impressive work,” and said the assistance centers are vital to the mission. He cited the case of a Grand Junction man who was very fearful and upset when he didn’t think he could afford health insurance. A health coverage guide spent considerable time walking the man through his options and Nevel said the man was so emotional when he qualified for health coverage and tax subsidies that he wept.
“There’s a learning curve for a lot of folks,” Nevel said. “It’s clear that without the assistance network, thousands of Coloradans would slip through the cracks.”
The members of the finance committee adjourned Thursday without voting to approve the new budget. The full board will consider it on Monday.