This is the second in a series, Women Leading Kentucky Health, of stories about four high-ranking female state officials who have guided the state’s embrace of the Patient Protection and Affordable Care Act.
The day after the Patient Protection and Affordable Care Act was signed into law, a reporter called the state Department of Insurance and asked what it all meant. The reply? People in the agency had to read it first – all 2,700 pages of it, Commissioner Sharon P. Clark recalled.
“We hit the ground running on March 24, 2010 and have continued since then,” Clark said in an interview. “It has been a lot of strain on the resources here and people’s time just to get a grasp of it. I am not exaggerating when I say there have been thousands of hours involved with it.”
Clark’s department is not in the Cabinet for Health and Family Services, but she is chair of the 19-member advisory board for Kynect, the brand the state uses for the health-insurance exchange Gov. Steve Beshear created under the law.
That strategic appointment was made by Cabinet Secretary Audrey Haynes, who said she realized early on how important it was to have the Insurance Department “at the table.” Haynes said the committee has had a “united front” since the beginning.
Clark attributes the success of Kynect, which has enrolled 521,000 people in health coverage, to collaboration and communication. “Everybody has just had to roll up our sleeves,” she said. “It has been the governor’s expectation that we work together and we get the job done. I don’t think any of us ever had any hesitancy with it.”
Clark, who was the Insurance Department’s director of consumer protection and education from 1998 to 2003, has seen the disruption and disasters that can happen to people without health insurance.
“I can’t tell you how much financial devastation there has been for people that did not have insurance coverage,” she said. They “have had, due to medical conditions, had to file for bankruptcy. … . I think anything that gives people the opportunity to get insurance has a significant impact on their lives.”
But the reform law and its implementation have been controversial, and Clark said, “The times continue to be challenging.”
One of the early challenges was making sure everyone was on board. Clark said it was important to the committee to make sure all stakeholders, such as hospitals, insurance agents and companies, doctors and the Kentucky Chamber of Commerce, were able to offer input and be involved in the process.
“The first collective voice was that Kentucky needed its own exchange” for people to sign up for health insurance or Medicaid, Clark said. She laughed and said, “I have been involved in government for over 20 years and it is rare that you get everybody saying the same thing.”
A more recent challenge has been President Obama’s decisions to allow states to extend existing health-insurance policies that don’t meet the requirements of the law for two more years, or policy years beginning on or before Oct. 1, 2016. Beshear allowed insurance companies to make such extensions.
Clark said the extensions created confusion in the marketplace. She said it is difficult for insurance companies to make such changes in mid-stream, because policy and technology systems have already been put in place toward compliance with the law.
The department’s major role in the new system is approving insurance companies’ rates, policies and forms. “We must approve the product or there is nothing out there to be sold,” Clark said.
Clark, like Beshear a longtime Democratic Party activist, says insuring Kentuckians will not only improve their health, but to also make a difference in their lives. “Health care is for all of us,” she said. “It is for all of us, society as a whole.”