Word: exchangees
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By far the most controversial detail is who would participate in these exchanges. Both the House and Senate plans would restrict access to small businesses and individuals not eligible for employer-sponsored plans that meet a set of minimum standards for coverage. Plus, while the House plan would at least...
Then there's the problem of adverse selection. Under the House plan, the exchange would be the only place private insurers would be allowed to market and sell individual insurance policies. But under the plan from the one Senate committee that has released legislation, insurers could still sell insurance outside...
According to Pollitz, insurers and insurance brokers would have a strong incentive to nudge sicker or older individuals or small groups toward the exchange, skewing the risk pool there and driving up premiums. "You just have to cherry-pick a little bit to be really profitable," says Pollitz. Both the...
Insurance exchanges are not a new concept. Under President Bill Clinton's ill-fated health-care plan, they were called "alliances"; in a current alternative bipartisan reform bill offered by Senators Ron Wyden and Bob Bennett, exchanges are called "health help agencies." And when members of Congress talk about offering...
Perhaps the most misunderstood aspect of the exchange proposals is the "essential health benefit package." Health-reform critics have been using this legislative provision to scare people into thinking that the government will decide what services are covered under private insurance. But what the government would actually be doing is...