Ferguson returns to roots to head health exchange

HEALTHY EXCHANGE: Christine C. “Christy” Ferguson was recently named the first director of the R.I. Health Benefits Exchange. She had previously worked at the R.I. Department of Human Services before taking jobs in Massachusetts and Washington, D.C. / PBN PHOTO/CATIA CUEN
HEALTHY EXCHANGE: Christine C. “Christy” Ferguson was recently named the first director of the R.I. Health Benefits Exchange. She had previously worked at the R.I. Department of Human Services before taking jobs in Massachusetts and Washington, D.C. / PBN PHOTO/CATIA CUEN

Christine C. “Christy” Ferguson, recently named the first director of the R.I. Health Benefits Exchange, is coming home – to work, that is.
Ferguson has commuted out-of-state to work much of the last decade, but says she has remained a resident of Jamestown. After she left the R.I. Department of Human Services in 2001 after a six-year stint, she worked in Boston from 2003 to 2005, serving as commissioner of the Mass. Department of Public Health under then-Gov. Mitt Romney.
Most recently, she has been working in Washington, D.C., as a professor at George Washington University, teaching about health policy and health-insurance issues.
The nation’s capital is familiar turf for Ferguson; she had spent 14 years, from 1981 to 1995, as counsel and deputy chief of staff to the late U.S. Sen. John H. Chafee.
Now, she’s back in Rhode Island, named by Gov. Lincoln D. Chafee, the late senator’s son, to head the state health-benefits exchange.

PBN: What’s it like to be back in the Statehouse?
FERGUSON: It’s exhilarating and interesting and strikingly similar to [my previous time] in many ways. In terms of people, it’s very different.

PBN: How has the body politic changed since you were last here?
FERGUSON: When I left state government, the economy was in a much different place, it was a bit better. But the economy certainly permeated a lot of the conversation then. Today, frankly, the health care [costs] for small businesses become incredibly important.
The gravity and concern about economics and the state budget, those things are even more intense than when I left in the early part of 2000.

PBN: Do you think that the tenor of the partisan debate has grown more strident, both at the state and national level?
FERGUSON: The difference, from my perspective, is between the federal and state governments. At the end of the day, the state has to balance its budget. The partisanship is less permanent and the disagreements are less permanent, it’s for a time-limited period. At the state level, there has to be an agreement to close the books. At the federal level, there’s a luxury of allowing the partisan debate to intensify, they can incur more debt and not come to a resolution.
State governments are much more practical animals, and they tend to be able to work out the really important crises.

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PBN: So, it’s a matter of federal versus state budgets? The political climate for dialogue, for compromise, has not worsened?
FERGUSON: If you go back in time, and look at the cartoons from the 1900s and 1920s, and what the parties said about each other and the disputes they had, it was pretty nasty. When I was … working in the Senate, I remember people who said, “It’s so partisan, no one talks to each other, I remember when you used to be able to sit down and have a conversation.”
Historically, every generation of people in politics believes that politics is more partisan than it was before.
Having said that, I do think it has gotten very challenging to deal with the level of complexity of problems such as health care, as well as other social programs and the economy, because of the speed of technology. It makes every single thing that anyone says fodder. It’s an environment that makes it harder to develop compromises.

PBN: How do you define the value of the new R.I. Health Benefits Exchange you’ll be directing?
FERGUSON: One, small businesses really need a place where they can easily access and buy well-designed options for their employees. That’s hard to do in the marketplace right now. They need a place that can start to help them to be more effective. That’s going to help the engine of our economy [in Rhode Island], which is small business. Two, the federal dollars [Rhode Island has already received] have allowed us to put together a much more streamlined and effective way of determining which health care programs people are eligible for, and to cut down on the costs.

PBN: What kinds of collaborative efforts will be necessary for success?
FERGUSON: I’m still working with people to get more comfortable with the conversations around health care delivery-system improvements, working collaboratively with the Medicaid program.

PBN: Is this new job a homecoming for you? Do you believe you can go back home again?
FERGUSON: I don’t feel like I ever really left. … I was a member of the Blue Cross & Blue Shield of Rhode Island board of directors, a position that I’ve left as a result of my new job.
From my perspective, one of the reasons I’m so delighted to join this team that Gov. Chafee and Lt. Gov. [Elizabeth H.] Roberts have put together is that they have really put this on the top of their agenda. The exchange is an important tool to implement for the good of the state. They have done a phenomenal job of keeping a steady course and continuing to push forward in reforming the health care system.
Rhode Island is way out in front of the nation. People are envious of where we are, and that’s because of the governor and the lieutenant governor.

PBN: What are the challenges you’ll need to overcome?
FERGUSON: I’m starting to make a list and catalogue all the major challenges. At the same time, I’ve also created a chart of all the great things that there are, so I don’t get overwhelmed by the challenges.
The biggest challenge is making sure we’ve got the information system that can meet the expectations of the federal government, and more importantly, the citizens of Rhode Island. That’s going to be a core assumption that we have to get right. •

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