Lessons Learned

Build ownership.
The broad workgroup involved in the development of the proposal and the wide swath of supporters involved early on fostered a sense of ownership for all involved and a stronger interest in seeing the proposal succeed.

Provide critical data.
Another lesson, according to various stakeholders, was the value of having actuarial estimates of what the program would cost. The workgroup worked with Mercer Actuarial Consultants to develop the proposal and cost estimates. The importance and credibility of this work was evidenced by the state using the workgroup’s funding recommendation.

Counter opposition early.
The workgroup that developed the original proposal tried to identify early on any possible opposition to offering subsidized coverage to families above 200 percent of the FPL. One tactic they felt helped avert opposition was the implementation of cost sharing that was relative to what families might pay in the private market. To ensure affordability for families, the workgroup chose a sliding scale premium structure to allow for a larger contribution by households with more income, while still keeping coverage affordable at the lower end of the income scale.

The workgroup weighed the cost sharing strategies against a family’s affordability to buy that coverage, an important consideration since cost-sharing levels have a direct correlation to participation.