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Explaining Health Insurance Exchange

The health reform acts that President Obama signed into law in the spring of 2010 call for the creation of health insurance exchanges. Many people are not exactly sure what this means. According to a letter President Obama wrote to Senator Ted Kennedy, he wants the health insurance exchanges to be �a market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that’s best for them.� This function is actually very similar to what insurance brokers currently do right now. However, some people do not know that they can shop around with the assistance of an insurance broker, for the same price as they could if buying directly from a health insurance provider. So at this time, the federal government wants to set up these health insurance exchanges, which is how members of Congress and their families choose their health insurance plans.

The idea of health insurance exchanges is to better organize the information out there about health insurance plans, to improve transparency within the health insurance industry, and to set it up in a more competitive market, in order to drive prices down. This would also allow for regulating some policies and procedures for the offering and pricing of health insurance plans. Another main goal of health insurance exchanges is to better educate the American public as to their health insurance options, help them become more familiar with the insurance vocabulary, and make the health insurance purchasing process less intimidating.

This is not the first time that health insurance exchange has been proposed in the government. Currently, there is a health insurance exchanges set up in Massachusetts, where it is called the Connector. Utah also has an active health insurance exchanges. In the past, they have been proposed as Health Help Agencies, which is just another name for health insurance exchanges. Regardless of what they have been called, Congress members have hoped these health insurance exchanges help the uninsured become insured, and facilitate changes and reform within the insurance industry.

To start out, the health insurance exchanges will mostly be beneficial to those individuals who need to purchase individual and family health insurance. Eventually, it is hoped that employers and employees can also choose health insurance plans offered through the health insurance exchanges, rather than having to enroll in whatever employer-sponsored group health plan is offered to them. This, again, increases the options and freedom of the American individual. Self-employed individuals would also greatly benefit from health insurance exchanges because they would be able to see the many different health insurance plans and policies available to them.

Information about health insurance plans would be presented in a straight forward, objective, unbiased manner. It is unclear at this time whether there will be one nationally-run health insurance exchange, or whether there will be regional health insurance exchanges. It may be more effective to have regional health insurance exchanges, but yet there may be lower overhead with one national health insurance exchange. These final decisions have not yet been decided. It is also unclear who will regulate health insurance exchanges, whether it will be done by the federal or state governments, or whether outside agencies will be in charge of the administration of health insurance exchanges.

Affordable Health Insurance Is The Goal Of Health Reform

One of the main goals of the health reform movement is that more American families will find affordable health insurance plans. Many of the changes being required of health insurance providers are designed to force them to offer more affordable health insurance policies to more Americans. In addition, there are also laws and regulations in place to force Americans to purchase affordable health insurance plans. In the future, American citizens who do not purchase affordable health insurance plans will have to pay big tax penalties or fines.

Another change is the establishment of high risk pools for each state. The purpose of these high risk pools is that individuals who have not been able to get approved for affordable health insurance individual policies in the past, due to a pre-existing medical condition, will have an affordable health insurance option. At this time, a few states have high risk pools, but many did not, as of earlier this year. This means that those individuals who were not enrolled in a group health plan may not have been able to find affordable health insurance plans because their monthly premiums may have been increased due to a pre-existing medical problem, or they would get denials back from their applications. High risk pools make it possible for these individuals to enroll in affordable health insurance plans. The premiums may still be higher, but the goal is to make affordable health insurance policies available to high risk citizens.

Many of the changes in the health reform acts laws to monitor and regulate the health insurance industry. This includes making health insurance providers submit rate increases to the government for approval. Again, this is to encourage insurance carriers to offer more affordable health insurance options to American citizens. The Secretary of Health and Human Services (HHS) is to create new rate review processes, and start approving or disapproving new rate filings by insurance companies.

Other changes proposed are the prohibition of lifetime benefit limits, restricted annual limits for essential benefits, and coverage of dependents up until age 26. All of these changes will result in less out of pocket expenses for members, therefore health insurance making affordable health insurance. The federal government really wants the public to see the benefit of health insurance, and find affordable health insurance policies in order to protect themselves and their families.

The HHS is also setting up a national insurance exchange, which is basically a web portal which will carry information from several different insurance providers and provide information about the many different types of affordable health insurance plans available to American citizens. It is possible that these insurance exchanges will also have information about a government-sponsored affordable health insurance, as competition to private open market affordable health insurance plans, such as those available to Americans today. The national insurance exchange is still a work in progress, so there is a lot to be seen about how it is to work.