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Health Care Reform Update: Insurance Exchanges and Insurer Risk Standards

First few Article Sentences

The Patient Protection and Affordable Care Act (PPACA) requires that by January 1, 2014, states operate health insurance exchanges to provide a competitive marketplace where individuals and small businesses may purchase affordable private health insurance coverage. It’s a colossal undertaking that also assumes the political willpower continues after the next presidential election. Even so, there is a lot to learn and much at stake right now for healthcare providers and employers of all sizes here in Washington State. In my opinion, the foundation of PPACA is not the constitutionally challenged individual mandate to purchase coverage, but the success or failure of Accountable Care Organizations and the State Insurance Exchanges. With recent rules published, the Exchanges are currently getting most of the attention.

According to the Department of Health and Human Services (HHS), the Exchanges will make it easier to compare health plan options, receive answers to health coverage questions, determine eligibility for tax credits for private insurance or public health programs and enroll in suitable health coverage. Individuals and small employers with up to 100 employees will be eligible to participate in the Exchanges, though until 2016, states can limit employers’ participation to businesses with up to 50 employees. Beginning in 2017, states may allow businesses with more than 100 employees to participate in the Exchanges. Causing additional confusion are the commercial “exchanges” already in play in some states – Washington included – that do not fall under these rules.


Fisher, Daniel, W.

 

EmSpring Corporation

Health Care Reform

October 1, 2011

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