Just trying to offer a little more input here on exchanges. This is posted by David Waymire, who handles communications for the Michigan Association of Health Plans, on behalf of MAHP Executive Director Rick Murdock.
Readers here should be aware that there are really only three options:
1. Put in place a state exchange operation, developed by state stakeholders including providers of insurance and consumers of insurance or
2. Letting the federal government impose its will on the state.
3. Doing nothing and crossing your fingers that the Supreme Court will hear this matter AND decide against all aspects of the Affordable Care Act before the law takes effect in 2014 - a position that is not very prudent. And if you are wrong, you will have effectively put the state back in position 2.
It's this problem that has resulted in the state Chamber of Commerce, Economic Alliance and Small Busienss Association of Michigan, among other business groups, to testify recently in support of Sen. Marleau's position and for exchanges. But there's even more.
Considering that Utah, one of the most conservative states in the nation, set up an exchange system in 2008 - before President Obama's election -- that meets the requirements of the federal law, it would seem that there may be merits to such a system even if it were not established in the Affordable Care Act.
Indeed, the conservative Heritage Foundation espoused the idea of an exchange back in 2006. http://www.heritage.org/research/reports/2006/10/the-rationale-for-a-statewide-health-insurance-exch
ange. It said then: "Americans get unlimited federal tax breaks for the purchase of health insurance if they receive that coverage through their workplace. Outside of the workplace, however, they almost always pay for coverage with after-tax dollars. Statewide health insurance exchanges are a solution to this inefficient inconsistency, giving individuals and families the opportunity to secure the health plans of their choice without losing tax benefits."
So let's look at what an state developed exchange might be able to do:
1. It's like Expedia for insurance. That means it's easier for consumers in a free market system to actually compare various products and pick the right one for him or her.
2. Insurers that don't want to participate don't have to. They will just not have their products listed on the exchange.
3. Insurers that want to participate will be working primarily under rules set up by the state, with their input.
4. There's no requirement for consumers to use the exchange to buy insurance.
It's easy to see why a state would want to set up an exchange system, even if the federal health care reforms had not included it. Just because it was included in the federal law is not sufficient reason to oppose it.
