Delaware Health Insurance Exchange

Delaware to Partner with the Federal Government to Develop their Health Insurance Benefits Exchange

In regards to implementing the changes made necessary by the Patient Protection and Affordable Care Act (ACA), Delaware has made what PricewaterhouseCoopers LLP’s Health Research Institute deems to be “moderate” progress. Seventeen states have been listed as “low” progress states, and thirteen states are considered to have made “high” progress. Delaware has a fairly low rate of uninsured residents, in comparison with the rest of the nation. With an uninsured rate estimated to be between 11 and 12%. Even with such a low percentage, in a state with our population, that still accounts for over 100,000 people without health insurance coverage.

Thus far the Delaware Health Care Commission (DHCC), operating under the direction of Delaware’s Department of Health and Human Services (DHHS), has been made responsible for the planning associated with implementing the Health Insurance Exchange. The DHCC has received two federal grants, the first one was for $1 million as a planning grant, and the second nearly $3.5 million as an establishment grant. These funds have been utilized to determine what type of Health Insurance Exchange is best for the state of Delaware and for its residents.

According to Governor Jack Markwell, Delaware does not plan to establish an independently run state exchange. Instead, it has been decided to work with the federal government on what is known as a partnership exchange. All states were given the option to develop and operate a state-run exchange, partner with nearby states to develop a regional partnership or to allow the federal government to operate an exchange in the state for the residents. Delaware has worked out a compromise solution based on the results and recommendations of the studies they have conducted to use the state’s strengths and bolster its weaknesses with federal assistance. It still remains for Delaware to decide how it is going to handle the Medicaid expansion, and the governor states they are awaiting further guidance from the federal government.

A Health Insurance Exchange, for those who are not as familiar with the terminology, is a marketplace wherein individuals, families and small businesses – all groups that have previously struggled to find access to affordable health care insurance benefits – will be able to review available plans to find one best suited to their needs. In addition to a listing of which plans are currently available, the exchange will provide available data on costs (both premiums and out-of-pocket expenses), coverage, member satisfaction ratings, member complaints and more so that their choice does indeed provide the best coverage for their situation.

What remains is for states that are lagging a bit behind on their progress, like our state of Delaware, to decide which mandates they will be taking care of and for which pieces they are going to rely on federal intervention. The good news is that as Delaware becomes more familiar with the requirements and the amount of work it requires to operate the exchange, they can opt to take on more and more of the responsibilities until they are able to develop their own state-run approach in later years.