Factors to be considered while setting federally managed Health Insurance Exchanges
In another 10 months all the U.S. states and the District of Columbia are expected to come up with workable models of their local health insurance exchanges for individuals and small businesses. President Obamaís Affordable Care Act of 2012 has designated January 1, 2013 as the state deadline to submit detailed blueprints of the proposed insurance exchanges and January 1, 2014 as the deadline for establishing fully operative web based insurance exchanges.
For launching successful insurance exchanges there are a lot of infrastructural, technological and insurance market related aspects that need to be addressed while designing these health exchanges. †
The exchanges will offer various health plans from different health carriers so that the consumers can compare different plans and can make an educated guess on the kind of health coverage they need. These online insurance exchanges will also allow consumers to check their eligibility for different products and benefits such as federal subsidies, Medicaid, small business tax credits etc. Health insurance exchanges will also need to collate and manage a common data pool with a lot of state and federal data on consumersí income, area of residence, employment etc.
There is also no clear information on how these insurance exchanges will look like or what computer upgrades, states and federal government will require for connecting to federal consumer data pool. Not only this, there are several ACA mandated regulations such as Ďessential benefitsí on which the final ruling is yet to be received by the federal government.
For states such as Alaska, Florida and Louisiana which have refused to move ahead with their health exchange plans and all the other states which are lagging behind in their HIX implementation plans, the Obama administration will move in to set up federally run insurance exchanges. Most U.S. states are awaiting Supreme Courtís ruling on the constitutionality of Affordable Care Act. If the Supreme Court declares that the Affordable Care Act is unconstitutional, then the entire ACA may get repealed.
However, if the ACA is upheld by the Supreme Court, the states which have not begun their health insurance exchange implementation plans yet, may not be able to submit their insurance exchange plans in time before the deadline of January 1, 2014. For such scenarios too, the federal government may need to establish separate exchanges in all these states.
Apart from setting up insurance exchanges in several U.S. states, the federal government will also need to integrate these exchanges with each other to ensure secure transfer and regular updating of consumer data to reduce error in medical care and analysis.†
Over the next few months it may become clearer as to what is the progress of federal health insurance exchanges, more so possibly after the Supreme Courtís mid-summer ruling. Until then, the U.S. healthcare insurance market will remain abuzz with the progress reports on the different statesí health insurance exchanges readiness status.
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Author is a well known authority on health insurance Exchange in the US. He is currently looking to expand his expertise in Health Insurance Exchange and state health insurance exchange available.