Health Insurance Exchanges Explained



there are a lot of changes happening in health insurance in the next couple of years and the exchanges are marketplaces that will allow consumers to have a choice of affordable options and also serve as a port portal for eligibility and enrollment in public programs and for premium subsidies through tax credits as well it's critical to realize that exchanges are a mechanism for obtaining coverage and that is occurring in the context of much more significant changes in the health insurance market specifically there will now be an individual mandate to obtain coverage and significant changes in the marketplace for the individual and small group market the Affordable Care Act requires that each state have an exchange and what the federal government has done is create three different ways that states can make that happen one way is through the state actually creating and running its own exchange and those are called state-based exchanges on the other end of this spectrum states decide that they really don't want to create their own exchange and the federal government will come in and do the work of setting up and running the exchange on behalf of the state and its residents then there's also a sort of a hybrid model which is called the state partnership model whereby the state and the federal government negotiate over what role the state will play and what role the federal government will play these exchanges will have a very significant role in the state insurance market and that is something that I expected States to want to have more control over a couple of factors I think have been significant one is the political environment and the uncertainty and another is that there is really a tremendous amount of planning and effort that needs to go into doing this successfully and I think there are states that took a really clear I'd look at what it would take and decided that they just didn't have the level of effort on the resources that would be required the states were concerned that they wouldn't have the time and and to some extent the information necessary to be successful there are a couple of sort of big buckets of things that are absolutely critical to success one of them is connectivity one of them is the information technology infrastructure that allows all these different systems and entities to talk to each other in relative real-time to create all the flow of information who it needs to go to when in a credible reliable secure way is an enormous challenge the second area is around consumer outreach and facilitating consumer decision-making to enable those who are enrolling to make informed decisions in line with their own values and preferences it has the potential to increase competition increase quality increase efficiency and make the entire insurance process much more easy and accessible for all kinds of different populations and individuals including all those previously uninsured who now are required to buy coverage it won't be easy but there is an unprecedented opportunity to make that happen in in our insurance marketplace

1 Comment

  1. Health Insurance is counter-productive, it produces opposite results. According to God’s law, “That which you sow, you shall reap” we must first get a medical problem; because our insurance payment is a seed we sow to get payment for a medical problem. The seed produces a medical problem. God says, Fear Not. Trust God, not man. Our freedom of religion means we do not need to get insurance. It is unconstitutional. We should be willing to face jail for our religion. They will lose their case.

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