Plenty of people have been saying for months, maybe years that, if anything in the Patient Protection and Affordable Care Act of 2010 (PPACA) could survive the death of PPACA, it would be the health insurance exchanges, or Web-based health insurance supermarkets.
Health insurers tend to see an exchange system as a tool for making sales more efficiently. Brokers hope that they can somehow participate in an exchange, or even set up an exchange of their own. Ardent libertarians may oppose the idea of the government getting involved with exchanges but like the idea of private organizations setting up exchanges.
Hating an insurance exchange is like hating newborn kittens. What’s the point?
Alan Cohen, chief strategy officer at Liazon Corp., New York, a company that runs the Bright Choices private health insurance exchange system, says the Supreme Court ruling on the constitutionality of PPACA shoulld be great for exchange programs, by clearing up much of the uncertainty about the PPACA exchange provisions.
Until, today, when the Supreme Court ruling upholding most of PPACA came out, “the court action kept everyone so frozen,” Cohen said. Now, he said, ”this will be the law of the land.”
Unless Congress intervenes, or states rebel, states or the U.S. Department of Health and Human Services (HHS) will have an obligation to provide exchange services that individuals can use to find any public programs for which they might be available or use new tax credits to buy private coverage. Small businesses also are supposed to be able to use exchanges to find coverage.
About 5 to 10 states seem to have the will, knowhow and technology programs needed to meet the PPACA exchange startup deadline, Cohen said in an interview. PPACA calls for HHS to be the exchange runner for states without their own exchange programs.
Traditionally, the term “private exchange” seems to give HHS officials the creeps, but now HHS officials, and state officials, seem to be getting the message that they can work with brokers and private exchanges to fill in gaps in their own skills, systems and knowledge, Cohen said.
Private exhange programs, for example, might already have the complicated systems needed to determine whether consumers are eligible for Medicaid or Medicare, Cohen said.
The more HHS is involved with running exchange programs, the better the situation should be for insurance brokers and private exchange operators that want to do business with the PPACA exchanges, Cohen said.
If, for example, HHS officials have to manage an exchange for residents of Idaho, they’ll soon learn that they have gaps in their knowledge about Idaho, Cohen said.
“The more centralized exchange control is going to be, the more they’re going to need local representation,” Cohen said.
So: The PPACA ruling could be great for LifeHealthPro readers who can figure out how to do profitable business with the exchanges.