Will the Health Insurance Exchanges Benefit Consumers? - DEBATED
General Reference (not clearly pro or con)
The Patient Protection and Affordable Care Act, Section 1311, "Part II—Consumer Choices and Insurance Competition through Health Insurance Exchanges," page 55, signed into law on Mar. 23, 2010, available at www.thomas.gov, states:
"(3) USE OF FUNDS.—A State shall use amounts awarded under this subsection for activities (including planning activities) related to establishing an American Health Benefit Exchange, as described in subsection (b)."
The US Department of Health and Human Services (HHS) stated the following in its Nov. 13, 2013 press release "106,185 Americans Selected Health Plans in First Reporting Period of Open Enrollment," available at hhs.gov:
"Detailing results of the first reporting period (Oct. 1-Nov. 2, 2013) of the Health Insurance Marketplace’s Open Enrollment, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that 106,185 individuals have selected plans from the Marketplace, and another 975,407 have made it through the process by applying and receiving an eligibility determination, but have not yet selected a plan. An additional 396,261 have been determined or assessed eligible for Medicaid or the Children’s Health Insurance Program (CHIP).”
Barack Obama, JD, 44th President of the United States, stated the following during an Apr. 2, 2014 speech "Remarks by the President on the Affordable Care Act," available at www.whitehouse.gov:
"Last night, the first open-enrollment period under this law came to an end. And despite several lost weeks out of the gate because of problems with the website, 7.1 million Americans have now signed up for private insurance plans through these marketplaces - 7.1."
Will the Health Insurance Exchanges Benefit Consumers? - DEBATED
The US Department of Health and Human Services (HHS), stated on its Aug. 23, 2012 posting "Creating a New Competitive Marketplace: Affordable Insurance Exchanges," last updated on www.healthcare.gov:
"Affordable Insurance Exchanges will provide individuals and small businesses with a ‘one-stop shop' to find and compare affordable, quality private health insurance options.
Exchanges will bring new transparency to the market so that Americans will be able to compare plans based on price and quality. By increasing competition between insurance companies and allowing individuals and small businesses to band together to purchase insurance, Exchanges will help lower costs."
Timothy Stoltzfus Jost, JD, Robert L. Willett Family Professor of Law at the Washington and Lee University School of Law, wrote in his July 2010 article "Health Insurance Exchanges and the Affordable Care Act: Key Policy Issues," available at www.commonwealthfund.org:
"Health insurance exchanges are the centerpiece of the private health insurance reforms of the Patient Protection and Affordable Care Act of 2010 (ACA). If they function as planned, these exchanges will expand health insurance coverage, improve the quality of such coverage and perhaps of health care itself, and reduce costs…
One valuable role that exchanges can play is to administer subsidies that assist lower- and middle-income people in purchasing insurance… Exchanges are ideally situated to administer these subsidies, as eligibility can be determined during the enrollment process, and the subsidies can be sent directly to the insurance plan chosen by each person."
The Los Angeles Times stated in its Feb. 8, 2012 editorial titled "'Obamacare' Insurance Exchanges: Let's Get Going":
"…[E]ach state should set up an exchange regardless of how its lawmakers feel about 'Obamacare,' because it would help ameliorate the very real problems consumers face in the health insurance market...
The main value for consumers is in the convenience and transparency the exchanges provide. No longer would they have to wander from agent to agent (or website to website) to find out what their options were. Nor would they have to try to translate each insurer's fine print to measure the total value of its policies. Enabling consumers to compare services and prices should remove some of the artificial barriers to competition in insurance and make it harder for companies to raise premiums."
The Robert Wood Johnson Foundation stated in its July 2012 issue brief titled "4 Ways State Health Insurance Exchanges Can Improve Quality," available at rwjf.org:
"1. Exchanges emphasize transparency in information about quality of care. Under the Affordable Care Act, states must ensure that plans participating in the exchange meet certain quality improvement criteria. The exchanges must also provide consistent quality and cost ratings for all participating plans—enabling customers to shop more easily based on quality, price, coverage, etc.
2. Exchanges can help link quality improvement with reimbursement strategies. Exchanges can coalesce insurance purchasers throughout the state—including Medicaid, the Children’s Health Insurance Program, state employee benefits programs, and private employers and their purchasing alliances—so that health plans hear consistent demands for quality that they, in turn, press upon their provider networks, sparking a tighter focus on quality care.
3. Exchanges can help consumers make more informed decisions. Exchanges' Web portals can provide consumers with relevant and actionable information, not just on the availability of affordable plans—but also on quality of care. Displaying easy-to-understand information on the quality of care provided by plans (based on the performance of their provider networks) enables consumers to make informed decisions and promotes quality-driven plans.
4. Exchanges can help fuel competitiveness, which in turn can make care more consumer-centered. By offering a choice of plans and equipping consumers with information to better understand and compare options, the exchanges can push plans to compete with each other to provide quality- and value-driven plans that work for consumers."
Families USA stated in its June 2011 article “Why We Need a Health Insurance Exchange,” available at www.familiesusa2.org:
"Consumers will greatly benefit once an exchange is in place. Here's why:
Competition: An exchange will make the state's insurance market more competitive. The exchange will force insurers to compete for customers based on value, instead of luring them with the trickiest fine print. The exchange will have an easy-to-use website that allows consumers to make apples-to-apples comparisons when they shop for health plans. On this level playing field, quality insurers of all sizes—not just the largest and most powerful—will be able to compete.
Transparency: Insurers in the exchange will have to use easy-to-understand language to describe their products—a vast improvement over the confusing jargon that consumers face now. And insurers will be required to share information about plan costs and quality in a standardized way so that consumers can truly understand what they're getting.
Affordability: In the exchange, middle-class consumers (those who earn up to nearly $90,000 for a family of four in 2011) will be eligible for tax credits to help them pay their insurance premiums.
Many people will also receive help with copayments, deductibles, or other cost-sharing. And the exchange will monitor insurers to make sure that they aren't unreasonably increasing their premium rates from year to year.”
The Minnesota Office of the Governor, and the Minnesota Departments of Commerce, Health, and Human Services, stated on their webpage “Exchange a Marketplace for Affordable Health Insurance,” available at www.mn.gov (accessed Sep. 7, 2012):
"An Exchange can make health care easier to navigate for consumers and small businesses. It can allow Minnesotans to easily compare health insurance options based on cost, quality, and consumer satisfaction. It can also foster fair and equitable competition to encourage insurers and health care providers to place a greater focus on value and affordability…
An Exchange can help small businesses provide affordable coverage choices to their workers and allow employees to choose the plan that is best for them and their families. Employees will be able to use contributions from one or more employers to purchase coverage for them and their families and keep that coverage if they become self-employed, lose their job, or if they change jobs. An Exchange can also simplify the administration of health insurance for small businesses and allow them to focus on growing their business instead of managing health insurance.”
The Center for Consumer Information & Insurance Oversight wrote on a page titled "Affordable Insurance Exchanges,” available at www.cciio.cms.gov (accessed Sep. 12, 2012):
"Competitive state Exchanges will keep prices low by:
* Increasing competition among private insurance plans through improved comparative shopping and more informed consumers
* Providing small businesses the same purchasing power in Exchanges as large businesses.
Additionally, the increased competition in the Exchanges--combined with provisions in the law to streamline administrative costs by standardizing forms and reducing the amount of paperwork doctors are forced to complete--will reduce average premiums by 7 to 10%, according to the Congressional Budget Office.
Provisions in the law that prohibit insurance companies from discriminating against Americans with pre-existing conditions will force insurance companies to provide high-quality benefits at a competitive price.”
Avik Roy, Senior Fellow at the Manhattan Institute for Policy Research, stated in his Nov. 19, 2012 article titled "What States Should Build Instead of Obamacare's Health Insurance Exchanges," posted at forbes.com:
"Obamacare takes [the exchange] concept and distorts it in a critical way, by taking over the insurance market and micromanaging the design of insurance plans that can be sold on the law’s exchanges.
...[T]he thrust of Obamacare’s exchanges is to shoehorn consumers into a narrow set of government-approved products, so as to protect them from making choices that the government deems unwise. The side effect of this approach is to prevent insurers from coming up with innovative products that deliver cost-efficient care...
Imagine if the government required that you could only buy a home that was between 2,000 and 2,500 square feet, with two bedrooms, five electrical outlets, and a solar panel, and you get a sense of what Obamacare's exchanges do."
Edmund Haislmaier, Senior Research Fellow of Health Policy Studies at the Heritage Foundation, stated in his Mar. 21, 2011 article “A State Lawmaker's Guide to Health Insurance Exchanges” available at www.heritage.org:
"Health insurance exchanges are a good idea—if they are used to implement patient-centered and market-based health reforms that enhance choices and value for customers. The exchanges prescribed by Obamacare will have the opposite effect...
Rather than serving as a mechanism for expanding health insurance choice, variety, and competition, and for spurring plans and providers to innovate and offer customers better value, Obamacare exchanges will impose new regulations, administer new subsidies, standardize coverage, and restrict consumer choice and insurer competition more than it is already. Thus, in the PPACA Congress has perverted the exchange concept into a bureaucratic tool for federal subsidization, standardization, and micromanagement of health insurance coverage by the Department of Health and Human Services.”
Ashton Ellis, JD, Contributing Editor at the Center for Individual Freedom, stated in his Mar. 15, 2012 article “ObamaCare Exchanges Consumer Choice and State Sovereignty for Nationalized Healthcare,” available at www.cfif.org:
"The Department of Health and Human Services promises that the creation of government-run health insurance exchanges will give states more flexibility and consumers more choices. But an examination of the rhetoric versus the reality reveals that these claims are just a smokescreen while HHS effectively nationalizes the entire health insurance market...
The initial cost is the loss of state sovereignty. While no state is required to operate a health insurance exchange, if it fails to initiate one by January 1, 2014, ObamaCare authorizes Secretary Sebelius to step in and do so. In the latter scenario, a state would be unilaterally cut out of any policymaking decisions regarding the portion of its residents that fall within the federal exchange's targeted consumer base...
Health insurance companies must meet certain standards to become qualified participants in the government-run exchange.
But because ObamaCare creates tax incentives and subsidies for purchasing plans on the exchange, many companies rightly fear that failing to qualify as participants will ultimately harm their businesses since those benefits are not extended to plans offered outside the exchange.
Thus, with the advent of government-run exchanges in 2014, the entire health insurance industry will be competing to please Secretary Sebelius and her army of HHS bureaucrats, not the millions of consumers compelled by the tax code to buy a one-size-fits-all health plan.”
Michael Cannon, MA, JM, Cato Institute Director of Health Policy Studies, stated in his Mar. 21, 2011 article “Obamacare Can't Be Fixed, and Now Is the Time to Dismantle It,” available at www.cato.org:
"Running their own exchanges won't empower states to prevent both the most economical and the most comprehensive health plans from disappearing from their markets. Affordable plans will disappear because Obamacare requires all purchasers to buy whatever coverage Sebelius mandates as ‘essential,' a definition that will grow ever broader, as such definitions always do. The law's price controls will require insurers to charge everyone of a given age the same premium, regardless of whether an actuarially fair premium might be $5,000 or $50,000. Even state-run exchanges would see comprehensive health plans crumble under the weight of too many patients who cost $50,000 but pay far less. Nor can state-run exchanges prevent other dimensions of quality from eroding. Even in state-run exchanges, the sickest patients would struggle to get their claims paid by insurers who are trying to avoid, mistreat, and dump them, because that is what Obamacare's price controls reward.
States that run their own exchanges will likewise be powerless to prevent HHS from loading health-savings-account (HSA) plans down with mandated benefits.”
Rita E. Numerof, MSS, PhD, Co-founder and President of Numerof and Associates, stated in her May 2012 article “What's Wrong with Health Insurance Exchanges,” available at www.galen.org:
"The health insurance exchanges defined in PPACA won't work, won't increase access to affordable health care, and won't do anything to improve health outcomes or increase value. The solution to affordable coverage isn't to be found in these new bureaucracies, but rather in reducing barriers to competition and consumer choice and removing regulations that make coverage unaffordable today…
PPACA's solution is to combine an individual mandate with health insurance exchanges, forcing consumers to choose from a limited slate of homogenized health plans, with federal subsidies available to some to offset the high cost of the plans.
PPACA's solution is fundamentally flawed and unsustainable: It will limit choice, create new bureaucracies, cost consumers and taxpayers more, and put additional burdens on the states.”
Rick Scott, Republican Governor of Florida, was quoted in a July 6, 2012 article titled "Gov. Rick Scott Repeats That Florida Will Not Implement Health Care Exchanges," published on www.tampabay.com:
"We're not going to implement the health care exchanges because it's not going to drive down the cost of health care, it's going to raise the cost...
The problem with the exchanges is the government is going to dictate the type of policies. The policies that will be on there are the kind of policies you might not want to buy…”
Twila Brase, President of Citizens' Council for Health Freedom, stated in her Feb. 27, 2013 op-ed titled "The Obamacare Exchanges Aren't 'marketplaces,'" posted at dailycaller.com:
"Words can deceive, as proponents of federal health reform know well. Calling the proposed state health insurance exchanges 'marketplaces' is nothing but a veiled attempt to use free-market terms to describe a system that is anything but free...
The reality is that on state insurance exchanges available health insurance plans will be limited by a host of federal regulations; personal privacy will be violated, because the exchanges will be connected to various state agencies and a wide variety of federal agencies — including the Department of Justice, the Department of Defense, the IRS, the Social Security Administration and the Department of Health and Human Services — that will share citizens’ data without consent; the federal government will use an individual’s income, tax, employment, medical, family and citizenship data to determine eligibility for coverage and premium subsidies; and it will be impossible to purchase health insurance without federal approval."