Many states will be setting up health insurance exchanges even if the Patient Protection and Affordable Care Act (PPACA) vanishes, and the exchanges that succeed will probably be the ones that do a good job of reaching out to brokers.
Ron Goldstein, president of CHOICE Administrators, Orange, Calif., gave that assessment Monday at a session on exchanges at the annual convention of the National Association of Health Underwriters (NAHU), Washington.
PPACA calls for states to set up exchanges, or Web-based insurance supermarkets, that individuals can use to sign up for public health insurance programs or use new subsidies to buy commercial coverage. PPACA also calls for states to offer SHOP exchange programs for small businesses, together with the individual market exchange programs or through separate systems.
States can choose whether to set up their own exchanges or let the U.S. Department of Health and Human Services (HHS) provide exchange services for their residents.
Many private groups and some states have been running exchanges or exchange-like programs since the 1980s.
Goldstein said he is confident that at least 15 to 20 states will be moving ahead with efforts to set up PPACA-influenced exchanges, even if the Supreme Court kills PPACA.
The states moving ahead with exchange programs include PPACA-backing states such as Oregon and Washington, but the list of states with fast-moving exchange programs also includes Arizona and Mississippi, Goldstein said.
CHOICE has found through direct experience in California that “you can’t have an exchange without brokers,” Goldstein said.
The companies that start and run exchanges are really technology companies, not sales, Goldstein said.
Goldstein said that HHS has been offering states a great deal of flexibility, and that the differences in state exchange programs could cause challenges for brokers and others.