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Life Health > Health Insurance > Health Insurance

Exchange World: Questions

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It’s been clear for months now that most major carriers, not wanting to jeopardize market share, are willing to roll the dice on participation in the state and federal exchanges.

We commend those at the U.S. Department of Health and Human Services (HHS) who have worked so diligently to have so many consumer choices available, and hope that the coming months are not a glitch-filled administrative nightmare.

Ultimately, the viability of the exchanges — and the costs of products on them — are going to be determined when the claims data comes in. It may be well and good that a healthy 27-year-old can get coverage for the cost of a cellphone bill, but will young and healthy 27-year-olds participate?

Or will the exchanges be populated with older, less healthy consumers or those with preexisting, expensive conditions?

Certainly the costs are going to be all over the map depending on demographics and age.

What we’ve seen in private exchanges so far is that participants tend to gravitate to the lowest-cost plans.

If those plans are very narrow in their access to doctors and hospitals, will there be a backlash — the same way there was a big public backlash against HMOs in the 1990s?

And with the massive subsidies through tax credits (for families making up to 400 percent of the federal poverty line), will this incent employers over the long haul to dump workers onto public exchanges?

These are the questions that will define the success or failure of Obamacare, and the answers aren’t going to be clear for a long time.

Our member firms sell more than 60 percent of the health insurance coverage for the 170 million Americans who receive their coverage through their workplace.

What we know so far is that the overwhelming majority of employers are working to comply with the law and continue their plans because they consider it an obligation and a competitive necessity.

With all of the hype about the Jan. 1 rollout, what we find more interesting is what is going to happen in the following year as employers get a chance to assess the implementation of the PPACA.

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