Plan Management: Issues for State, Partnership and Federally Facilitated Health Insurance Exchanges – RWJF

This paper funded by the Robert Wood Johnson Foundation, and authored by a joint team from Georgetown University’s Health Policy institute and the National Academy of Social Insurance, provides insight for state and federal officials considering how they will assume responsibility for managing health plans once health insurance exchanges are established. Under the Affordable Care Act, one of the core functions that state health insurance exchanges must engage in is plan management—including activities like certifying qualified health plans, collecting and reviewing rate and benefit information, managing contracts, monitoring ongoing compliance issues, and running an open enrollment process, among others.

via Plan Management: Issues for State, Partnership and Federally Facilitated Health Insurance Exchanges – RWJF.

Christie Vetoes Health Insurance Exchange for New Jersey – NYTimes.com

In a swipe at President Obama’s signature health care legislation, Gov. Chris Christie of New Jersey vetoed on Thursday an online marketplace that the Legislature created to help residents and small businesses buy health insurance.

via Christie Vetoes Health Insurance Exchange for New Jersey – NYTimes.com.

What’s In A Name: Health Exchanges, Marketplaces … Or Swap Meets – Kaiser Health News

If a Medicare staff recommendation is approved, health insurance exchanges may be up for a rebranding.

Because, Medicare officials say, consumers understand words like “marketplace” better.

“We are recommending not using the word ‘exchange’” in enrollment materials, Julie Bataille, director of the CMS Office of Communications, said last week at a meeting of outreach advisers. And while she didn’t mention the preferred substitute, she dropped hints.

“Words like ‘marketplace’ resonate much more with the consumer and also tend to be something that is all inclusive,” she added.

via What’s In A Name: Health Exchanges, Marketplaces … Or Swap Meets – Kaiser Health News.

No Obamacare Exchanges – Michael F. Cannon – Townhall Finance Conservative Columnists and Financial Commentary – Page 1

Here are just a few reasons why states should refuse to create them.

Jobs. Refusing to create an exchange will block Obamacare from imposing a tax on employers whose health benefits do not meet the federal government’s definition of “essential” coverage. That tax can run as high as $3,000 per employee. A state that refuses to create an exchange will spare its employers from that tax, and will therefore enable them to create more jobs.

Religious freedom. In blocking that employer tax, state officials would likewise block Obamacare’s effort to force religious employers to provide coverage for services they find immoral — like contraception, pharmaceutical abortions, and sterilization.

The federal debt. Refusing to create exchanges would also reduce the federal debt, because it would prevent the Obama administration from doling out billions of dollars in subsidies to private insurance companies.

The U.S. Constitution. The Obama administration has indicated that it might try to tax employers and hand out those subsidies anyway — even in states that don’t create an exchange, and even though neither Obamacare nor any other federal law gives it the power to do so. If that happens, the fact that a state has refused to create an exchange would give every large employer in the state — including the state government itself — the ability to go to court to block the administration’s attempt to usurp Congress’s legislative powers.

via No Obamacare Exchanges – Michael F. Cannon – Townhall Finance Conservative Columnists and Financial Commentary – Page 1.

Helping Consumers and Employers Make Better Health Plan Choices: What’s in the Tool Box? – Health – AEI

Effective choice and competition in health insurance will require better information about the quality and efficiency of health insurance plans. Regardless of whether proposed health insurance exchanges under the Affordable Care Act are ever implemented successfully, consumers and employers need better tools to compare the relative cost and quality of the health care they are likely to receive under different plan options.

At this forum, Robert Krughoff of the nonprofit Consumer’s CHECKBOOK/Center for the Study of Services will unveil his organization’s recommendations for a best practices health plan comparison tool that would assist insurance purchasers in selecting plans that best meet their needs and preferences. Sam Gibbs of eHealth Government Systems will describe what the nation’s leading online source of health insurance for individuals, families and small businesses is doing to present complex health insurance information in an objective, user-friendly format. They will both discuss how better health information tools could improve the performance of health exchanges, health insurers and health care providers.

via Helping Consumers and Employers Make Better Health Plan Choices: What’s in the Tool Box? – Health – AEI.

State-Run Insurance Exchanges in Federal Healthcare Reform: A Case Study in Dysfunctional Federalism by Kyle Thomson :: SSRN

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (“ACA”) into law, resulting in the most sweeping reform of the healthcare marketplace and one of the largest expansions in access to healthcare in American history. A key component to both restructuring the healthcare marketplace and improving access are the health insurance exchanges contained in the ACA. Today, individual and small group purchasers have difficulty finding affordable health insurance on the marketplace because they lack the tools to gather information about plans and because they lack the bargaining power to negotiate for affordable rates the way large purchasers can. In conjunction with the individual mandate, the health insurance exchanges aim to solve inefficiencies in the current marketplace by creating a centralized venue to connect insurers with individual and small business purchasers. Thus, it both creates a place for insurers to readily find customers, who are now guaranteed to be there because of the individual mandate, and provides a place for customers to shop for insurance. Rather than creating a national health exchange, and, in turn, a unified national insurance market, the ACA adopts a familiar federalist model that requires state-run exchanges to implement federal policy. This Note argues that the federalist structure of the insurance exchanges contained in the ACA is inefficient and ultimately self-defeating, both from a functional federalism perspective and because of the significant constitutional and political challenges it invites.

via State-Run Insurance Exchanges in Federal Healthcare Reform: A Case Study in Dysfunctional Federalism by Kyle Thomson :: SSRN.

Corporate Health Care Exchange Survey | Aon

Nearly all employers (94%) are committed to offering and financially supporting health benefit coverage for their workforce in the foreseeable future.

The commitment is there but what about the solution? The average cost of health coverage per employee crossed the $10,000 mark for the first time in 2012*. The cost of health care is projected to increase at an average rate of 7% to 10% in 2012. Meanwhile, salaries are expected to increase about 3% on average. This tenuous dynamic, coupled with the fact that many employees are becoming more educated and better stewards of their own health care choices, makes now the ideal time to explore other health care coverage options, including Exchanges.

To better understand employer views on Health Care Exchanges, Aon Hewitt surveyed 562 organizations nationwide.

via Corporate Health Care Exchange Survey | Aon.

White House Quietly Increases Budget for Obamacare’s Exchange Subsidies by $111 Billion – Forbes

If employers dump many of their workers onto the exchanges, as numerous independent analyses suggest is likely, taxpayers may need to spend as much as $200 billion a year extra on these exchange subsidies. Well, it turns out that the Obama Administration agrees that initial spending estimates are too low. The White House’s fiscal year 2013 budget adds $111 billion in exchange spending between 2014 and 2021, with even more spending to come in future years.

via White House Quietly Increases Budget for Obamacare’s Exchange Subsidies by $111 Billion – Forbes.

Helping Consumers Choose Health Plans In Exchanges: Best Practice Recommendations – Health Affairs Blog

The Health Insurance Exchanges required under the Patient Protection and Affordable Care Act (ACA) have the potential to create markets that will help millions of Americans get affordable health insurance coverage and access to high-quality care. The exchanges can enhance consumer and employer buying power to improve the overall quality and efficiency of the health care system.

To reach those results, Exchanges will have to be effective in various challenging functions. A key function is giving consumers and employers a health plan comparison tool to assist them in selecting the plans that best meet their needs and preferences.

Without such a tool, consumers will make plan choices that are bad for themselves and possibly bad for the health care system. Tests done by the Pacific Business Group on Health (PBGH)  have found that “participants do only slightly better than chance at selecting the ‘best’ plan, even in simplified environments.” Research by Consumer Reports has found that consumers “dread” shopping for health insurance, and that the “difficulties are so profound that the vast majority of consumers are essentially being asked to buy a very expensive product—critical to their health—while blindfolded.”

via Helping Consumers Choose Health Plans In Exchanges: Best Practice Recommendations – Health Affairs Blog.

Oregon Legislature Blocks ObamaCare ‘Exchange’ | Cato @ Liberty

A coalition of 30 Republicans and 1 Democrat in the state House of Representatives blocked approval of Oregon’s health insurance exchange this morning…

Last year, a bill to set up the exchange passed both houses of the Legislature with broad bipartisan approval.

via Oregon Legislature Blocks ObamaCare ‘Exchange’ | Cato @ Liberty.