The Health Insurance Marketplace Brings Needed Changes

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1 The Health Insurance Marketplace Brings Needed Changes

2 Healthcare Reform is showing early returns. The Health Insurance Marketplace can help it work even better.

3 The U.S. Department of Health and Human Services reported that just a single provision of the Affordable Care Act (ACA) the Medical Loss Ratio Rule requiring insurance companies to spend percent of premiums on actual healthcare delivery led to more than $1.1 billion being given back to 12.8 million consumers for 2011 health coverage, for an average award of $151 per qualifying household. This was the result of reducing the amount of premium spent by health insurers on administrative overhead*. And that s just the beginning. The most important provisions of the Affordable Care Act won t be in full effect until 2014 and beyond, but even at this early stage of implementation, healthcare reform is making a positive difference in the lives of millions. But because the ACA is a multifaceted, comprehensive approach designed to increase access to healthcare while controlling costs, elements of the ACA must be in place for healthcare reform to succeed. Among those elements key to the ACA s success is the Health Insurance Marketplace, also known as Exchange. *U.S. Department of Health and Human Services, June 21, THERE IS NATIONAL BIPARTISAN SUPPORT FOR HEALTH INSURANCE EXCHANGES The Health Insurance Marketplace A logical solution to a problem ignored for far too long. Total Democrats Independents Republicans 42% 37% 10% 9% 55% 37% 5% 2% 35% 40% 12% 11% 26% 36% 17% 17% Very favorable Somewhat favorable Somewhat unfavorable Very unfavorable Note: Don t know/refused answers not shown. Source: Kaiser Family Foundation Health Tracking Poll (conducted Dec. 8 13, 2011) 4

4 The Health Insurance Marketplace is an online shopping outlet that can be operated by either a state, the federal government, a federal-state partnership, or a multi-state partnership. Private health insurers (national, regional, state and local) are invited to offer standardized, transparent, easy-to-compare plans for which individuals and small businesses can shop. In the Health Insurance Marketplace, administrative costs that insurers incur to sell coverage to individuals and small businesses are reduced. The healthcare risk and the associated costs are also spread across a greater number of people by pooling individuals and small employer groups into larger groups. This pooling mechanism gives individuals and small businesses many of the same advantages that large employers already have when they buy health insurance in spreading risks across a large pool of their employees. In the Marketplace, new insurance AT A GLANCE: KEY ISSUES rules will also require insurers to compete on the basis of price and quality and not on the basis of selecting the healthiest applicants, as they often do today. These features will work to help control overall health insurance costs. Moreover, the Marketplace is the way to deliver federal financial assistance to help those with low and modest incomes pay for their insurance and health insurance tax credits to qualified small businesses that purchase coverage for their employees. The Health Insurance Marketplace will: Help more people enroll in a health insurance plan Make it easier to shop for and compare insurance options Ensure consumer protections Enable insurers to compete more efficiently Reduce time and costs for small businesses Help control overall healthcare costs 40% 30% 20% 10% 0% The ACA and the Exchanges will end premium discrimination of individuals and small businesses 12.7% TOTAL 40.9% INDIVIDUAL 35.8% % % Costs of health insurance overhead for identical coverage as a % of claims by group size prior to ACA implementation 21.8% Data: Estimates by The Lewin Group for The Commonwealth Fund. Source: Commonwealth Fund Commission on a High Performance Health System, The Path to a High Performance U.S. Health System. A 2020 Vision and the Policies to Pave the Way (New York: The Commonwealth Fund, Feb. 2009) % 13.5% % 500-2, % 2,500-9, % 10,

5 The Health Insurance Marketplace can t work unless it s used. The Health Insurance Marketplace is a key component of the Affordable Care Act and critical to the success of Healthcare Reform s overriding goals to increase access to healthcare for more people, improve healthcare quality and control costs for individuals, businesses, and healthcare providers. The Congressional Budget Office estimates that the Marketplace will help reduce insurance costs for small businesses and individuals while they help increase coverage, so this is an historic opportunity to help improve the economy and people s lives in our states. Therefore, it's vitally important for us to reach out to each state s eligible citizens and solicit their enrollment and continued participation in the Marketplace. 9

6 The Health Insurance Marketplace will open Oct. 1, 2013 for coverage beginning Jan. 1, 2014, so it s critically important to have an outreach and education effort successfully operating as far in advance of this date as possible. Ascension Health asserts the Health Insurance Marketplace should: Provide equitable access to all eligible participants, regardless of income level, eligibility for private or public coverage, or any other factor Let s make the Marketplace work harder. Many individuals and small businesses are unaware of the Marketplace or whether they qualify for enrollment. They need help navigating the enrollment process. Organizations such as Enroll America, along with a ready coalition of stakeholders including insurers, hospitals, clinicians, other healthcare providers, retail pharmacies and pharmaceutical companies, consumer and civic organizations are ready to assist in implementing best enrollment practices. AT A GLANCE: KEY ISSUES Feature appealing, easy-to-use interfaces that compel people to use them Appeal to small businesses Offer pre-qualified provider networks and ensure access to locally-based plans Be financially stable Make health-plan metrics widely available and consistent with other public and private quality metrics Emphasize transparency Similarly, Ascension Health is advocating specific principles for operating the Marketplace. Help control overall healthcare costs 11

7 The Health Insurance Marketplace will help people. AT A GLANCE: KEY ISSUES If we have enough enrollment and continued participation in a robust, well-run Marketplace that follows Ascension Health s principles, the Health Insurance Marketplace will: Streamline marketing functions to reduce the costs of selling insurance to small businesses and individuals Promote transparency and competition in the small-group and individual markets Make it easier for consumers to evaluate and compare alternative health plans Enhance small employers ability to get value for their dollars and enhance their employees access to an expanded choice of plans that are appropriate to their needs Reduce administrative time and costs related to finding and keeping health insurance for the smallest groups and individuals Improved access to healthcare is an economic imperative for, and a moral measure of, our states. High enrollment and continued participation in the Marketplace is key to that goal, and states should do whatever is in their power to make sure that it is fully functional in time for the first open enrollment beginning Oct. 1,

8 71 MILLION PEOPLE MAY OBTAIN COVERAGE THROUGH THE HEALTH INSURANCE Exchanges BY m 146m 25m 22m 55m 34m 28m Medicaid /CHIP Private Insurance Coverage through the Exchanges Job-Based Coverage 26m 46m Private Insurance Coverage outside the Exchanges Uninsured Estimated number of people that will have coverage through the Exchanges. Sources: Congressional Budget Office estimates of current law, March 2012; Congressioinal Budget Office, Estimate of the Effects of the ACA on Health Insurance Coverage, February

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