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Health Insurance Exchanges

Health Insurance Exchanges: Making them healthy

If you’d forgotten, you may recently have started to see more news about the Health Insurance Exchanges that are an integral part of Obamacare (the Affordable Care Act). These programs are beginning to take shape, due to come on line in January 2014. The Exchanges—connecting individual health insurance buyers with insurance companies offering qualifying policies—are the vehicles by which millions of Americans are expected to obtain health insurance, many of them for the first time. One set of formal calculations projects that as many as 24 million households should obtain health insurance this way by 2019. Most of the individual participants are expected to be people who currently do not have health insurance, for a variety of reasons. For example, many may work for small businesses that don’t offer health insurance benefits to their employees; that’s true of approximately half of all small businesses and it affects millions of workers.

The ACA has been controversial, so there could be more arguments, but the Supreme Court decision and President Obama’s reelection lessen the likelihood of further challenges. With procedural steps being taken to build the Exchanges, the question increasingly turns to making the Exchanges work so that they serve their purpose.

Health Insurance Exchanges illustrated by this family medical practice signThe Health Insurance Exchanges situation reminds us of a prior piece of legislation, the Children’s Health Insurance Initiative (CHIP), that was designed to make health insurance available to the children of working people who made enough to be above the poverty line but still struggled economically—an uncomfortably large portion of our country. When CHIP was implemented an early discovery was that, partly due to the complexities of the rules, many eligible households did not realize it applied to them and consequently didn’t apply. A communications effort funded by the Robert Wood Johnson Foundation called the “Covering Kids Initiative (CKI)” was designed to fix that problem by motivating potentially eligible participants to act on their own behalf. We were excited to be part of the strategic message-building team on this communications effort. It helped the CHIP program succeed in expanding the numbers of eligible people who actually enrolled to get their children insured.

This motivation challenge plays to a top Artemis priority: helping organizations—whether government, private or a combination, as in the Health Insurance Exchanges context—understand how people think about the issue at hand in order to build communications that reach the right people with meaningful messages that drive them to act.

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