State to award computer contract for health insurance marketplace

May 31, 2012

By Daniel Weintraub
California Health Report

California’s new Health Benefit Exchange – the online consumer portal that will be at the center of federal health reform – took a major step Thursday toward implementing the controversial law that could extend insurance coverage to millions of Californians.

The Exchange announced its intent to award a $360 million contract to Accenture LLC to design and maintain a web site that will allow consumers to shop for insurance, choose their plan and enroll.

“We want this experience to be as easy as buying a book on or buying a ticket on StubHub or buying shoes on Zappos,” said Peter V. Lee, the Exchange’s executive director. “It needs to be as simple and as seamless as we can possibly make it.”

The online enrollment system will be backed up by staff available to help consumers by phone and in person, and by tens of thousands of “navigators” in community organizations, churches and hospitals who will be trained to guide people through the system. Multiple health insurers are expected to offer varying levels of coverage, and the state’s goal is to make comparison shopping among them easy for the average person.

The Exchange expects to be helping more than 4 million Californians find insurance through state programs or subsidized private coverage by 2016.

“This is the biggest change to the American health system since Medicare,” Lee said. “We need to have the information and tools that will speak to different people where they are in ways they can understand.”

The federal Affordable Care Act has been challenged in court and the case is pending at the US Supreme Court, which is expected to rule by the end of June. The case is focused on a provision of the law requiring nearly every American to have insurance coverage beginning in 2014 or face financial penalties, but it is possible that the court could strike down the entire law, including authorization for the Health Benefit Exchange.

But Lee said he thinks that outcome is extremely unlikely.

“No one has questioned the vast majority of what’s in the Affordable Care Act,” he said. “No one has questioned the federal government’s authority to help states establish exchanges.”

The contract with Accenture would be financed by federal money that is part of the reform law, and the federal government must approve it before the state can sign the deal. If the Supreme Court were to strike down the entire law and end the flow of federal money for health reform to the states, the contract would be void, Lee said.

“There is zero potential that the general fund in California will be on the hook for this,” Lee said.

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