To say that the Affordable Care Act has been controversial among business owners is the understatement of the decade.
Since its passage in 2010, and indeed, for some time before that, it has been as reviled by majority of the business community as it is feared. And yet, despite recent attempts by the Republican party to "repeal and replace" Obamacare, there's little reason to believe it's going anywhere any time soon.
And so, rather than rage against the inevitable, some savvy entrepreneurs like Sally Poblete are approaching the country's changing healthcare system as the greatest of opportunities.
Poblete is CEO of Wellthie, a nine-month old startup that's helping insurance companies better communicate their coverage to potential customers. Wellthie licenses its Affordable Care Advisor software to insurers, so that when people visit that insurer's site, they see exactly what subsidies and tax credits they're eligible for under the Affordable Care Act, as well as a price comparison across different plans. Now that some 50 million uninsured people across the country are required to buy their own insurance, the need for better communication in the industry has become urgent. It's so urgent, in fact, that in less than a year, Poblete has landed three insurance companies, including EmblemHealth, as clients.
In an industry that's notoriously slow moving, Poblete says, "That's unheard of."
Before launching Wellthie in May 2013, Poblete, an 18-year veteran of the insurance industry, was working at WellPoint as a vice president of product and business strategy. Even as an insider, she says, she was awestruck by the complexity and opacity of the insurance industry. When the Affordable Care Act was signed into law in 2010, Poblete says, she had her "aha moment."
"I thought, 'You've already got a complex industry and complex product, and then you're going to have this brand new law that's going to add more rules and regulations, but also opportunities like tax credits to all these consumers who are buying insurance for the first time,'" she says. "How can they possibly navigate and make sense of it all?"
Like many entrepreneurs, Poblete obsessed over the idea for years before finally taking the leap and launching the company last year. "It's such a big problem," she says. "I wanted to be part of the solution, and the best way I thought I could do that was to create a company."
Poblete is far from the only entrepreneur to notice this need, but while many have built a platform for consumers, Wellthie is unique in that its end clients are insurance companies, themselves.
"As a startup, creating a business to consumer company is hard," Poblete says. "I thought that could be a path for us in the future, but for now, working with insurance companies would be the fastest way to reach end consumers."
Wellthie's software uses a complex formula to calculate peoples' premiums, based on federal government regulations, state regulations, the insurance company's own policies, and the individual's background. The software lives on the insurer's website and only offers suggestions based on that insurer's plans.
It's a similar tool, Poblete admits, to the state and federal insurance exchanges, but she says the two can be complimentary. "It's like a consumer going to Travelocity or to AmericanAirlines.com," she says. "I don't think people will go to the exchange and end there. Consumers want to get more information, and my belief is the plan that offers a simple experience and answers their questions will win consumers over."
Having a tool like this was especially advantageous for insurers when the Healthcare.gov website was down late last year.
So far, more than 100,000 calculations have been made through Wellthie, though Poblete says she hasn't yet calculated the total number of customers who have actually enrolled in a plan.
As successful as Wellthie's first nine months have been, however, Poblete admits breaking into such an intransigent industry will continue to be a challenge for the startup going forward. "It's hard to change old habits," she says. "When we're talking to clients, it can be a delicate balance to to say, 'That's the old way. This is the new way.'" And because people will inevitably have to buy their insurance through the exchanges, even after using Wellthie's tool, it may be tough to prove that Wellthie played a part in converting that customer.
Even as Wellthie grows its customer footprint with insurers, it's developing additional products to tackle other obstacles people are facing due to the changing healthcare landscape. One product Poblete says she expects to release this year is a tool for business owners to help them make decisions about employee coverage.
"As an entrepreneur, I know there's a need for businesses to figure out the right choices for them," she says. "That's next on our roadmap."
Poblete hopes that now that millions of people, many of whom have never had insurance, are required to pay for coverage, themselves, the insurance industry will take more initiative in properly educating the public. "My hope is that we can make consumers feel more confident about their health insurance and feel that sense of value," she says, "so they can say, 'I paid $4,000 for this, and I feed good about it.'"