Word: pollitzer
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...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 the exchanges. This is a recipe for failure, according to Karen Pollitz, a health-policy researcher at Georgetown University. "Anytime you've got competing markets, there is an opportunity for risks to get shifted," she says. (Both the House and Senate plans would allow, but not require, small businesses to participate, with the House plan opening the door to larger and larger companies...
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 House and Senate plans call for regulations and rules to prohibit this. But, as Jacob Hacker, a health-policy expert at Yale University, puts it, "The real concern comes down to having adequate resources for enforcement. It's one thing to have rules and another thing to make sure insurance...
...problem with health insurance," says Karen Pollitz, a health-policy expert who has studied the shortfalls of HIPAA, "is it's really complicated and fixing it part way almost never works." Some skeptics of the insurers' support this go-round believe that's what the industry is counting on, even if its advocates and defenders insist that's just what they are working to avoid...
Between Coverage and Safety Net Pat's decision to save some money by buying short-term insurance was a big mistake, says Karen Pollitz, project director of Georgetown University's Health Policy Institute and a leading expert on the individual-insurance market. "These short-term policies are a joke," she says. "Nobody should ever buy them. It is false security that is being sold. It's junk...
CHECK OUT ASSOCIATION COVERAGE. Many institutional and professional groups, including alumni associations, offer well-priced coverage to members. But don't assume that your group has chosen a good company, says Karen Pollitz, project director at Georgetown University's Institute for Health Care Research and Policy. Before signing up with any insurer, see whether its customers lodge a lot of complaints: go to "Consumer Information Source" at www.naic.org the National Association of Insurance Commissioners site. Check quality ratings at www.ncqa.org the National Committee for Quality Assurance site. And before using an insurer based out of state, ask your state...