In 2013, Kevin Counihan will be in for a sprint of a lifetime.
He’s the man in charge of getting Connecticut’s health insurance exchange running and that means he must move at a breakneck pace to meet an aggressive October deadline.
That’s when open enrollment for the statewide exchange — an online marketplace that will allow individuals and small businesses to shop for insurance — is scheduled to begin.
“This is a three-and-a-half-year implementation being done in 10 months,” said Counihan, who is CEO of the Connecticut Health Insurance Exchange. “This is really a high pressured environment.”
Counihan said he envisions exchanges becoming a primary way for people to obtain health insurance in the state but there is a lot of work to be done before that becomes a reality. The exchanges are mandated as part of the federal health care reform law, and are seen as a key way to expand access to insurance coverage.
Counihan won the CEO job over a pool of 75 other candidates because he has deep experience in dealing with exchanges. Most recently, he was president of Choice Administrators Exchange Solutions in Orange, Calif., which helps states create exchanges under the federal Patient Protection and Affordable Care Act.
With the major policy decisions already decided, the next important milestone for Connecticut going into 2013 is getting insurers signed up to offer coverage within the exchange, Counihan said.
That will ultimately determine the competitive environment for small businesses and individuals looking to access affordable coverage.
Counihan said he is optimistic that many of the major players in the market — Aetna, Cigna, Anthem, Oxford Health Plans — will offer coverage in the exchange.
Meanwhile, new players in the market including HealthyCT and Harvard Pilgrim Health Plans have also expressed a desire to offer coverage within Connecticut’s exchange.
There is also a carrot and stick deal in place. Counihan said policies adopted by the 13-member insurance exchange board require insurers who agree to sign up for the exchange to offer coverage for at least two years. And if an insurer refuses to initially participate in the exchange, they will be locked out for two years.
“The more carriers that participate the better off the residents in the state will be,” Counihan said. “The current system is not affordable for small businesses and individuals. No one finds the status quo to be acceptable.”
The other two major hurdles faced by Counihan and his team will be getting the actual digital interface of the exchange operational, and informing individuals and businesses about its existence.
On the interface side, Counihan said KPMG is project manager while Deloitte is actually creating the exchange system. They are in the design stage, but they must have the system up and ready for testing by April.
The key will be creating a system that effectively links together various state and federal government agencies. Small businesses and individuals who obtain insurance through the exchange will be eligible for various tax credits and subsidies.
Making the system easy to use will be crucial in getting the 120,000 or so uninsured people who are expected to be eligible to buy subsidized insurance through the exchange to use it, Counihan said.
And of course relaying the message that the exchange is available to small businesses and individuals has its own complications.
“This is not something that is top of mind to most people,” Counihan said. “It’s a new way of purchasing health insurance for most people in this state. But we have a moral obligation to make this work and let people know this option is available to them.”
