Discounting Healthcare: ACA & Health Exchanges

Jun 21
02:22

2013

sammy smith

sammy smith

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Obamacare has been a God-sent for people who have been suffering from the vagaries and excesses of the American healthcare insurance system. Statistics reveal that the American health insurance marketplace has been highly unregulated and functions in many ways that deters the cause of providing insurance to everyone, including the underprivileged.

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Perhaps,Discounting Healthcare: ACA & Health Exchanges Articles this is why Obamacare is also referred to universal insurance since it seeks to provide insurance to the poorest of people, including the minorities and those who are left uninsured despite the presence of state and federal health insurance syndicates like Medicare and Medicaid.
The Affordable Care Act is at the heart of Obama’s health reforms. This act seeks to create a regulated, streamlined and open marketplace where people can buy insurance without any bias. These markets are called Exchanges. The ACA mandates that every state sets up its own exchange or an insurance marketplace. This can be done in three ways. States can either create their own exchange called a state exchange or default out of creating an exchange and depend upon the federal government’s federal exchange.
The third option is becoming quite popular, particularly towards the end of 2012 and the early part of 2013 where more and more states seek to enter a partnership model with the federal government. These are being referred to as federal-state health exchanges or Hybrid Insurance marketplaces where the division of responsibilities will be individually decided by each state in coherence with the federal government.  
The ACA seeks to correct many of the wrongdoings that have resulted in higher premiums being charged by insurers. For instance, the insurers getting listed on the federal or state exchanges will have to perform in accordance with audits and rules of the Act. This includes introduction of caps on how much an insurer can spend on salaries of its executives, including the high-ranking personnel, marketing, etc.
Further, the insurer cannot weed out an insurance claim on flimsy grounds such as data mistakes incurred during the process of signing up for insurance.
Greater choices that would be created by the presence of numerous insurers on the private exchange marketplace will ensure that premiums are kept at their competitive best. However, insurance companies would have to abide by some rules such as prohibition on denying insurance based upon preexisting conditions. Similarly, insurance companies will lose the luxury of denying insurance based upon race, gender, age, family history of diseases or personal history of illnesses. 
The role of the health insurance exchanges is rather easy to understand, i.e. they will serve as marketplaces where small businesses and individuals will be able to access the same insurance choices that are offered to the members of Congress or the President. This will include viewing plans on the web that offer different range of out-of-pocket expenses, premium payment terms, etc. along with the lure of tax credits or subsidies for some plans.
This is why the state exchanges have also been dubbed as one-stop insurance plan shopping resources. Since all the relevant information about each health plan will be provided in a standardized format, consumers will have assured access to easy-to-understand information. This kind of consumer-focused approach has been missing desperately from the manner in which the health insurance sector has been operating until now. These conditions will be listed as a part of exchange enrollment for payers.
Accepting the fact that the presence of an open, consumer-centric insurance marketplace is the way forward, insurers too are updating their medical insurance software solutions. They are now adopting technologies that help them portray in a manner similar to the health exchanges. For instance, many of them are now creating private health exchanges where their entire list of health insurance products will be presented. Such private exchange will have a series of consumer assisting tools like a Medicare quote engine or an insurance quote engine that will have automated functionalities. Insurance software vendors are in the process of creating such personalized healthcare software systems for payers across the nation.