Will the health insurance exchanges benefit consumers?


General Reference (not clearly pro or con)
Bill Leonard, Senior Writer at the Society for Human Resource Management, stated in his Mar. 25, 2010 article "Health Care Exchanges Will Alter Competition and Choice," available at www.shrm.org:

"The idea behind the exchanges is to create marketplaces where health insurance providers compete for customers on equal terms. Supporters of the idea claim that competition in the exchanges among insurance providers will help to lower premium costs and make health plans more affordable - especially to low- and middle-income families.

The exchanges will be open to anyone without employer-provided coverage who wants to purchase a health insurance plan. Families with annual incomes between $30,000 and $88,000 (four times the national poverty rate) will be eligible for premium subsidies from the federal government for plans purchased through the exchanges. Families of four with incomes less than $30,000 per year will become eligible for Medicaid under the new law."


Mar. 25, 2010 - Bill Leonard 



PRO (yes)

The US Department of Health and Human Services (HHS), stated in its timeline entry "Establishing Health Insurance Exchanges," www.healthcare.gov (accessed Sep. 16, 2010):

"Starting in 2014, if your employer doesn’t offer insurance, you will be able to buy insurance directly in an Exchange that gives you power similar to what large businesses and members of Congress have to get better choices and lower prices. An Exchange is a new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans. Exchanges will offer you a choice of health plans that meet certain benefits and cost standards."

Sep. 16, 2010 - US Department of Health and Human Services (HHS) 



Timothy Stoltzfus Jost, JD, Robert L. Willett Family Professor of Law at the Washington and Lee University School of Law, stated 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."


July 2010 - Timothy Stoltzfus Jost, JD 



Bryce A. Williams, JD, President and Chief Executive Officer at Extend Health Inc., stated in his Apr. 16, 2010 article "Viewpoint: Group Policies vs. Subsidized Individual Coverage - The Impact of Exchanges," available at www.shrm.org:

"The state-run health insurance exchanges coming online in 2014 will likely make a huge difference to Americans who have been shut out of our largely employer-sponsored health insurance system...

Being part of an exchange has benefitted individual retirees as well. Just as employers gain greater control over long-term obligations, retirees now have a dependable stipend to pay for health care expenses. Historical data shows that, on average, retired couples who buy supplemental Medicare insurance through the exchange see a $500 a year reduction in total out-of-pocket medical expenses— not an insignificant amount, especially for people on a fixed income in a time of ever-increasing medical costs...

No one likes change—it’s disconcerting to many and frightening to some. And health care is a highly charged, very sensitive issue. But after initial skepticism, even the vast majority of individual retirees who have purchased insurance through a private exchange report high satisfaction with their plans, the prices they paid for them and the experience of buying from an exchange. This is because, in the end, exchanges take the fear, uncertainty and doubt out of the health care system for everyone involved.

Exchanges are not a silver bullet, and transitioning active employees from group plans to an exchange would be a change of seismic proportions for any employer. But exchanges are coming, and for employers, the time to explore and educate themselves and their employees about them is now."


Apr. 16, 2010 - Bryce A. Williams, JD 



Maine House Democrats, stated the following in their Sep. 21, 2010 press release "Health Insurance Exchanges Seen as Way to Increase Security and Ensure a Fair Playing Field for Maine Families and Small Businesses," available at www.maine.gov:

"Health insurance exchanges will increase competition among insurance companies and will help individuals and small businesses combine their purchasing power to get better deals – just like big businesses and other organizations already do. Exchanges will increase choice, increase competition and increase the quality of the products offered. The exchange will require legislative action in the coming months in order for people in Maine to take advantage of all of the benefits...

Exchanges will also make it easier for individuals and small businesses by creating a one-stop shop for getting information on prices and benefit packages. Purchasing insurance on the individual or small group market can be daunting if you aren’t a human resources professional. The exchanges are a way to design and implement a user-friendly way for families and businesses to learn about health insurance options and benefit from the reduced-price health insurance that will be available in 2014, when the law is fully implemented."


Sep. 21, 2010 - Maine House Democrats 



CON (no)

John S. Hoff, LLB, Secretary and Founding Board Member of the Galen Institute, stated in his Sep. 10, 2010 article "Implementing Obamacare: A New Exercise in Old-Fashioned Central Planning," available at www.heritage.org:

"PPACA [Patient Protection and Affordable Care Act] gives the Administration the power to con­trol every aspect of private insurance sold in the exchanges. It requires the insurers to take all appli­cants and to charge all members in an area the same premium regardless of risk (with exceptions for family coverage, tobacco use, and age).  Although the law does not give the Administration explicit authority to regulate the level of insurance premiums, through a web of reinforcing provisions, it gives the Administra­tion the de facto power to do so...

The Administration will create mountains of regulations that will govern these activities. Health care will be politicized and made more cumbersome. The flexibility of providers and patients will be greatly reduced and creativity sup­pressed. Individual choice will be subordinated to decisions made by central authority. The regulations issued by the government will be grist for private litigation against providers and insurers. PPACA sets in motion dynamics that will increase the cost of health care, reduce its flexibility, and ultimately prove anathema to the kind of health care that Americans want."


Sep. 10, 2010 - John S. Hoff, LLB 



Robert Tracinski, Editor and Publisher of the Intellectual Activist, stated in his Dec. 20, 2009 article "Congress Focuses on Increasing Government Power in Reform Plan," available at www.heartland.org:

"The biggest power-grab of all is the government takeover of the entire market for health insurance. Both the House and Senate bill require all new policies to be sold on a government-controlled exchange run by a commissioner empowered to dictate what kinds of insurance policies can be offered, what they must cover, and what they can charge.

Right now your best option for reducing the cost of your health insurance is to buy a policy with a high deductible, which leaves you to pay for routine checkups and minor injuries... but covers your needs in catastrophic circumstances - a bad car accident, say, or expensive treatment for cancer. But the health-insurance exchange is intended to eliminate precisely this kind of low-cost catastrophic coverage. Its purpose is to force health-insurance companies to offer comprehensive coverage that pays for all of your routine bills - which in turn comes at a higher price...

So under the guise of making health insurance more affordable, the Democrats’ plan will restrict your menu of choices to include only the most expensive options. It restricts your choice of which insurance to buy and pushes us all into more expensive plans. At the same time it destroys the economic incentive to purchase insurance in the first place and replaces insurance with a free-floating tax on one's very existence."

[Editors Note:  In March 2010, President Obama signed the Patient Protection and Affordable Care Act (HR 3590), the Health Care and Education Reconciliation Act of 2010 (HR 4872), and Executive Order 13535 which restricted federal funds from being used for abortion services. Pro, Con, or Not Clearly Pro or Con positions made prior to the final wording of these three elements of the health care reform legislation may have changed since March 2010.]


Dec. 20, 2009 - Robert Tracinski 



Tom A. Coburn, MD, US Senator (R-OK), stated in his July 2010 report, cowritten with Senator John Barrasso(R-WY), "Bad Medicine: A Check-UP on the New Federal Health Law," available at www.heartland.org:

"Premiums will also increase due to a new fee health insurance companies will have to pay to sell plans in the federally-mandated, regulated exchanges. CBO [Congressional Budget Office] estimates plans would have to pay a surcharge to sell in the exchange, which could add about 3 percent to premiums...

[I]f a person who applies for premium credits in an exchange is determined to be eligible for Medicaid, the exchange will have that person enrolled in Medicaid.  Health reform should give all legal residents – American citizens and legal immigrants – more choices in their health care, not merely access to a substandard government program [Medicaid]."


July 2010 - Tom A. Coburn, MD