An Exchange by any other Name…

Shakespeare_transcript_pulloutIn Shakespeare’s play Romeo and Juliet, Juliet surmises that, “Romeo would, were he not Romeo call’d, retain that dear perfection which he owes without that title.” So in the same sense would not Health Exchanges by any other name still be just as confusing?

“’Tis but thy name that is my enemy”
A recent survey conducted by the Research Intelligence Group found that less than half of those eligible for lower cost health care through these upcoming Health Exchanges actually knew about it. Another survey found the number to be as high as two-thirds. Some of the confusion around Health Exchanges can be attributed to negative views about health care reform in general. A Gallup poll released in July found that 52% of Americans disapproved of the Affordable Care Act (ACA). A Kaiser Family Foundation Health Tracking Poll found similar results, however noted that about 18% of those with an unfavorable view believe the ACA did not go far enough. The remaining 80% of those with an unfavorable view believe the law goes too far and is overreaching. The Kaiser poll also found that despite the negative attitude towards the ACA, when called “Obamacare” the favorable ratings increase by 7%.  This is roughly the same percentage as those who believed the ACA does not go far enough, highlighting the deep partisan divide among supporters and detractors of the law.

“O, be some other name!”
The lack of awareness and understanding of Health Exchanges can also be attributed to confusion about what to call them. In January, the Department of Health and Human Services began calling Health Exchanges “Health Insurance Marketplaces”.  According to a GAO report the Federal government will run these Marketplaces in thirty-four states nationwide using the same name, look, and feel ( However, there are 17 other states that have received letters from CMS granting conditional approval to run their own state-based exchanges. These health exchanges do not necessarily have to be called “Health Insurance Marketplaces” and in many instances will not use that nomenclature or the branding as the Federal website. For example, the state of California spent $900,000 to contract with Ogilvy Public Relations Worldwide. The task is to develop an advertisement and awareness campaign for their newly dubbed health exchange called Covered California. In the meantime the state of California maintains both a health exchange website ( and a newer customer-friendly website ( as they march towards the October 1st open enrollment deadline.

“A rose by any other name”
New York received conditional approval to run a state-based exchange back on December 14, 2012; roughly one month before California.  As a result, the New York Health Exchange recently hired BBD Worldwide, one of the few advertisement firms still on Madison Avenue, to develop a comprehensive marketing and advertisement campaign for the New York Health Benefit Exchange. One of the first tasks at hand for the firm will be re-branding. Despite being roughly 60 days out from Open Enrollment on October 1st, with more than 2.3 million New Yorkers uninsured, the state will launch a new name for the Exchange in the coming weeks.

Many other state-based exchanges have also changed their names and branding. See chart below for details on a few.


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