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Healthcare Policy Analysis Essay

Its finally happening!We get to manage our own health care .Our issues with Healthcare and insurance is finally looking up in a positive way .Finding a doctor won’t be such a hassle nor will it be someone else telling you who you have to pick . Insurance won’t be so high and even has made it possible to carry insurance without it breaking our pockets each month .This new way of insurance marketing is a great idea . I feel this will save our pockets and cost of health care can finally go down .The facts are exceptional and putting a great attitude in a lot of people to feel good about going to a physician again .

For the first time in most states, small businesses and consumers who do not have affordable health insurance through an employer will be able to select coverage with the confidence that they will be offered a plan, and that their premiums will predominantly reflect its value, rather than their health, gender, or occupation. Also for the first time, individuals with incomes under $92,000 for a family of four will be eligible for subsidies to help pay their premiums for plans sold through the exchanges. It is essential that federal and state governments continue to work hard to ensure that all Americans who lack health insurance can begin shopping and signing up for coverage nine months from now.What a marketplace indeed .

A health insurance marketplace otherwise known as health insurance exchange .This is a government regulated and standardized health care plans in the United States. Individuals may purchase health insurance eligible for a tax reduction . All exchanges must be fully certified and operational by January 1, 2014, under federal law. The federal government has spent $2.2 billion to help states establish their health insurance exchanges, which require creating websites to let millions of small businesses and individuals in every state buy health insurance from qualified health plans.Seventeen states and the District of Columbia have received conditional approval from HHS to operate a state-run marketplace in 2014. These states are: California, Colorado, Connecticut, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont, and Washington. HHS’ approval of these marketplaces is conditioned on the states addressing a short list of issues highlighted in the review process.

This Issue Brief examines issues related to managed competition and the use of a health insurance exchange for the purpose of addressing cost, quality, and access to health care services. It discusses issue that must be addressed when designing an exchange in order to reform the health insurance market and also examines state efforts at health reform that use an exchange. The basic component of managed competition is the creation an organized marketplace that brings together health insurers and consumers (either as individuals or through their employers).The sponsor of the exchange would set “rules of engagement” for participating insurers and offer consumers a menu of choices among different plans. Ultimately, the goal of a health insurance exchange is to shift the market from competition based on risk to competition based on price and quality.

Among the issues that need to be addressed if an exchange that uses managed competition has a realistic chance of reducing costs, improving quality, and expanding coverage: Everyone needs to be in the risk pool, with individuals required to purchase insurance or face significant financial consequences; effective risk adjustment is essential to eliminate risk selection as an insurance business model forcing competition on costs and quality; the insurance benefit must be specific and clear without standards governing cost sharing, covered services, and network coverage there is no way to assess whether a requirement to purchase or issue.has been met; and subsidies would be necessary for low income individuals to purchase insurance. The public plan option is shaping up to be one of the most contentious issues in the health reform debate. Proponents also believe a public plan is necessary to drive private insurers toward true competition. Opponents view it as a step toward government run health care and are wary of cost shifting from the public plan to private insurers. There were three key events significantly impacted the legislative session. Obamacare Became the Law of the Land,With the Supreme Court’s decision to uphold the individual mandate and President Obama’s reelection, supporters and opponents of the health reform law now accept that like it or hate it the Affordable Care Act is here to stay.

This reality shifted the political tone at the Capitol, resulting in less of the fierce rhetoric from years past. Most of Colorado’s Republican lawmakers remain opposed to federal health reform, but several bipartisan bills were passed to help facilitate a smooth implementation of the law. Colorado democrats took control of both chambers and the balance of power remained the same in the colorado Senate, with Democrats holding a 20-15 seat majority. Control of the Colorado House of Representatives, however, shifted from Republicans to Democrats, who picked up five seats for a 37-28 seat majority.With control of both chambers and a Democratic governor the Democrats wielded significant power in getting their agenda passed. The economy saw slow But steady progress and difficult budget discussions and painful cost cutting dominated previous legislative sessions, but this year’s Joint Budget Committee had an easier task. Colorado’s economic recovery outpaced the nation, and General Fund dollars were up 5.5 percent in fiscal year (FY) 2013-14. With more money in state coffers, legislators restored cuts and made new investments in health care and other programs. The budget passed on a party-line vote, with Democrats praising it as a smart and strategic approach to state spending and Republicans saying it isn’t prudent enough and doesn’t spend money in the right places.

Open enrollment in the Affordable Care Act’s new state insurance exchanges begins in October 2013, with coverage beginning in January 2014. For the first time in most states, small businesses and consumers who do not have affordable health insurance through an employer will be able to select coverage with the confidence that they will be offered a plan, and that their premiums will predominantly reflect its value, rather than their health, gender, or occupation. Also for the first time, individuals with incomes under $92,000 for a family of four will be eligible for subsidies to help pay their premiums for plans sold through the exchanges. It is essential that federal and state governments continue to work hard to ensure that all Americans who lack health insurance can begin shopping and signing up for coverage nine months from now.With some help from our key players health care just might work this time . Thank Obama and his team for another shot in a another chance at good health .

Fronstin, Paul and Ross, Murray N., Addressing Health Care Market Reform Through an Insurance Exchange: Essential Policy Components, the Public Plan Option, and Other Issues to Consider (June 2009). EBRI Issue Brief, No. 330, June 2009. Available at SSRN: http://www.ebri.org/http://ssrn.com/abstract=1426184

https://www.statereforum.org/exchange-governance
http://www.apihealthcare.com/hwie?_kk=hie&_kt=afa5ea9c-2ead-4efc-84dc-d7e709e1a31b&gclid=CLKB_7aQpLkCFY9AMgodsVcA6Q Molly Voris of the Washington Health Care Authority shared the state’s enacted Exchange enabling legislation. Access the legislation here: http://www.statereforum.org/sites/default/files/final_5445.pdf T. S. Jost, Health Insurance Exchanges and the Affordable Care Act: Eight Difficult Issues, The Commonwealth Fund, September 2010.

References
Oapi healthcare (2013). Welcome | State Refor(u)m. Retrieved from https://www.statereforum.org/

T. S. Jost, Health Insurance Exchanges and the Affordable Care Act: Key Policy Issues, The Commonwealth Fund, July 2010.


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