Policymakers must address adverse selection, eligibility determination, administrative costs and other critical issues if they are to make health insurance exchanges work, according to a report released last week by the Commonwealth Fund.
State health insurance exchanges, mandated by the Patient Protection and Affordable Care Act, become operational in 2014; in 2017, states will be permitted to open them to large employers. The report, Health Insurance Exchanges and the Affordable Care Act: Eight Difficult Issues, identifies eight of the most difficult issues state and federal policymakers will face as they implement these exchanges and offers recommendations for addressing them.
The author, Timothy Stoltzfus Jost, a Washington and Lee University School of Law professor, explores ways exchanges can make insurance more available to consumers (including employers) and how to help consumers make better choices. The Commonwealth Fund is aprivate foundation supporting independent research and promoting a high performance health system that achieves better access, improved quality, and greater efficiency, especially for the underserved.
The impact on hospitals is indirect but nevertheless significant. “Obviously, if exchanges can be made to work, hospitals will have more insured and fewer uninsured patients. More active competition among insurers, however, is likely to encourage insurers to drive better bargains with providers, including hospitals,” he tells HealthLeaders.