Analyzing the State of Health Insurance Exchanges in the US healthcare
With increasing numbers of employers dropping employer-sponsored coverage and many individuals losing their insurance coverage owing to rising costs, health insurance exchanges are expected to see high enrollments from the US individual and group insurance markets.
The United States of America has over 50 million people who do not possess health insurance. Escalating healthcare costs,
families discontinuing health coverage to rein in costs, employees losing employer sponsored coverage, recession etc., have all contributed to the growing number of uninsured in America. President Obama's Affordable Care Act of 2010 had pledged to cover at least 32 million uninsured Americans through the health insurance exchanges.
The federal government has granted US states the autonomy to design their state exchanges as per the state exchange administrators deem fit. To maintain consistency in operational principles and ensure compliance with federal mandates, the US Department of CCIIO has released a an exchange blueprint document that provides states some common guidelines on how to approach and proceed with the exchange design approval and implementation programs.
Beginning January 1, 2014, the state health insurance exchanges are scheduled to launch across the entire US. If the health insurance exchanges launch as per the scheduled time line, US individuals and small businesses would be able to purchase their health insurance from the affordable insurance exchanges at competitive rates. However, with so much debate revolving around ACA's individual
mandate clause and the entire act, it is yet to be seen, how many US states would be able to successfully comply with the federal insurance deadline. If the Supreme Court upholds the Affordable Care Act, then all the US states would need to set up exchanges or risk the federal government stepping in to run its own exchange.
For setting up insurance exchanges, the federal and state exchanges would need to work together to develop a business model for accurate verification and assessment of millions of US individuals' personal and financial details. Just enrolling individuals in health plans would not solve the purpose, so states need to ensure that the consumers are enrolled in appropriate health plans. States would also need to calculate the financial aid that all households would be entitled to based on their financial metrics.
At present, the state of health insurance exchanges in the US healthcare landscape appears dismal with only 13 states and Washington DC, moving ahead with their exchange plans, out of the total 51 US states. The US states are likely to see much action in the health insurance exchange implementation plans only post the Supreme Court's ruling on the constitutionality factor of Affordable Care Act. If the act gets repealed, the states would no longer be mandated to establish state health insurance exchanges and if the Supreme Court upholds the Act, the states would need to
abide by the federal guidelines and establish health insurance exchanges before the January 1, 2014 deadline.
