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February 19, 2013
From the desk of |
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One common misconception among the general public is how large the market will be for the state Health Insurance Exchange under the Affordable Care Act (ACA). The target population eligible for purchasing coverage through the Health Insurance Exchange is really very small – less than 10 percent of the population on average. Most of us get our health insurance through our employer, and if we work for a large employer, the employer negotiates the best deal it can on our behalf and presents us with a plan or choice of plans. The Health Insurance Exchange is targeted to those who do not have access to employer-based insurance and those working for small employers (50 employees or less). The idea is for the Health Insurance Exchange to act on behalf of those who do not have the advantage of a large employer to do so. In this scenario, I am an advocate of an “active purchaser” model where the Health Insurance Exchange actively tries to leverage the market to negotiate the best value (low cost and high quality) that it can for exchange enrollees. Here is a great chart by Kaiser that demonstrates the shift in the distribution of health insurance coverage under the ACA and where people will be covered. Again, the Health Insurance Exchange is a very small but important part of health reform.
Further reading on Health Insurance Exchanges “When is an ‘Exchange’ an ‘Exchange’?” – Lynn Blewett “Insurance Exchanges: Lessons, Recommendations, and Analysis” – SHADAC |
