President Obama signs PPACA (AP photo/J. Scott Applewhite)

A health policy watcher says the new public health insurance exchanges should provide consolidated billing, even if that’s a headache.

Expecting the consumers who are using the exchanges to pay separate bills for each product purchased is unrealistic, according to Elisa Cafferata, president of Nevada Advocates for Planned Parenthood Affiliates.

Cafferata talked about a potential PPACA exchange plan bill blizzard problem in a comment letter sent to the Silver State Health Insurance Exchange board.

The board, which runs the state-based Nevada Health Link exchange, has said it will send a family that signs up for coverage through the exchange one consolidated bill.

Recently, the board has been debating a proposal to simplify its glitch-plagued operations by billing families separately for each product.

Cafferata said billing for each product separately would be a nightmare, because current PPACA rules can funnel the individual members of one exchange-using family into several different plans.

One child could end up with Medicaid, another child could get coverage through a Children’s Health Insurance Program plan, and the parents could each buy separate commercial “qualified health plans,” Cafferata said.

A family in that situation might also end up with stand-alone dental coverage from one or more carriers, Cafferata writes.

“These are also the families having a difficult time making it on a day-to-day basis,” Cafferata writes. “And they generally are not familiar with these complicated systems.”

Expecting families that are already on the edge to be able to track and pay several bills each month could be a considerable burden on those families, Cafferata writes.

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