Coming To Your State Soon!

The Federal government will establish health insurance exchanges regardless of how the Supreme Court rules on the Affordable Care Act – whether the states act or not.

In her Health Care Blog article, The Case For the Exchanges, Maggie Mahar drives home the inevitability of the Exchanges.
Beginning in 2014, insurers may begin to sell health insurance policies on an exchange where individuals and small businesses can shop for and compare health insurance plans. Minimum standards for policies include:
  • Covering “essential benefits.”
  • Capping out-of-pocket expenses for individuals.
  • Offering  transparent information about costs and benefits.
  • Not turning down or charging them higher premiums to customers suffering from chronic illnesses.

The Patient Protection and Affordable Care Act (PPACA) calls on the states to create health insurance exchanges. Each state is supposed to have an exchange up and running by 2014, or leave its state’s consumers to use a federal exchange instead.

This link shows what each state is doing about it.

Some states are balking. Florida, Louisiana and Alaska say they will not set up exchanges,  and some are balking. The American Prospect reports that some states have slowed down while awaiting the Supreme Court ruling on the health law.

In order to retain as much control as possible, John Godman advises states to “engage in preemptive reform over the next two years.”

The Supreme Court Won’t Make Any Difference

The Supreme Court may strike down the individual mandate which requires that Americans buy insurance or pay a penalty, but during oral arguments before the Court, only two or three of nine Justices seemed to accept that the mandate is “the heart of the law.”

Linda Bergthold  opines in a Health Insurance Resource Center post, that the most likely outcome is that the body of the law will remain intact regardless of whether the mandate is overturned.

Reform is a Process, Not an Event

The May 16 government draft blueprint specifies that “the process of establishing an exchange may extend beyond the first date of operation and may include improvements and enhancements to key functions over a … period of time.” The states will continue to receive grants throughout 2014, with three additional years to spend them. The Department of Health and Human Services will offer to partner with them, most likely designing enrollment, processing applications for subsidies, and staffing call centers to field the bulk of consumers’ questions.  There is no need for each state to do it alone.

Reform Will Gather Steam

J.D. Power & Associates study released in March shows that voters are becoming more aware of the exchanges – and most want the opportunities they will offer. The Center on Budget and Policy Priorities’ Judy Solomon suggests that politicians of all stripes will feel the pressure from their constituent residents to institute the same coverage that their neighboring states receive.

Maggie Mahar is a financial journalist and author of Money-Driven Medicine: The Real Reason Health Care Costs So Much, which inspired the documentary, Money Driven Medicine. She wrote and edited the Health Beat blog for The Century Foundation, authored  Health reform: a huge victory for women, and provides background on Congressional health care legislation for, a project of theHealth Insurance Resource Center