But one of the actuaries who addressed the forum said allowing people to keep their existing policies through 2016 will likely lead to premium increases over the next two years. James T. O'Connor, principal and consulting actuary at Milliman, said the two-year extension will likely lead to the healthiest people sticking with their existing plans and the least healthy people switching to exchange plans for more affordable comprehensive coverage. "We will see rates set somewhat higher… due to the transition policies," he said.
An Uninformed Consumer
Several forum speakers said maintaining outreach and education efforts in 2015 will be a major challenge because of the costs associated with the kind of face-to-face contact that is most effective in educating consumers about the new public exchanges.
"If you look at the uninsured, they are very uninformed," said Rosemarie Day, president of Day Health Strategies in Somerville, MA. "That's a problem and a gap that has to be closed."
Cammie Blais, CFO of the public exchange in Colorado, said face-to-face educational efforts are the most effective way to reach consumers, but the cost of maintaining those kinds of outreach programs will be impossible for most states to maintain. "It's very time consuming and we need to make those programs more targeted," the Connect for Health Colorado CFO said. "We can't sustain that effort long-term."
Blais said Colorado exchange officials are looking for partners in the private sector and public assistance agencies to help carry the educational burden in 2015 and beyond. She said one strategy is to work with health plans, agents, and brokers to provide education about the exchanges to consumers. "We've included them from the beginning," she said, adding it will be a challenge to keep some brokers and agents engaged in the exchanges. "Many, many of them are frustrated with the process. It's unclear how many of them will participate in 2015."