Yesterday Health and Human Services Secretary Kathleen Sibelius released initial Health Insurance Exchange Rules. While not final, these rules set the tone for how we can expect the Exchanges to eventually look.
HHS’s regulations give states a lot of flexibility in how they choose to implement their exchanges -giving them the option to regulate what plans may be included in the exchange and not requiring states to participate in price negotiations. According to the American Health Insurance Providers (AHIP), this leeway gives people greater options when they participate in the exchange. While AHIP makes a valid point, we must consider the purpose of the Affordable Care Act and health care reform. If the single purpose of reforming the health insurance system is to lower the cost of health care then perhaps AHIP is on the right track. Yet, we believe cost reduction is not the sole goal, but instead that improving care for all people should be an equally important goal . American health insurance should not only be cheaper, it should also be better, a step forward the ACA provides for handily. We are not only trying to create insured Americans, we must also seek to create healthy Americans.
While the Affordable Care Act (ACA) does a lot on its own to protect consumers -eliminating coverage denial on the grounds of pre-existing conditions, expanding covered benefits for women, and regulating gender disparities -it shouldn’t be ignored that in a lot of ways the ACA plays directly into the hand of insurance providers. For instance, by 2014 almost all Americans will be required to buy insurance, opening a huge new market for insurance providers. Given this, we find it hard to find empathy for AHIP’s cries that regulation of the new Health Insurance Exchanges will lead them to financial insecurity. If Americans are being required to buy insurance, then with these regulations HHS does not require states to go far enough to make it worthwhile for them. Allowing states, but not requiring them to negotiate prices with Insurance companies does little to increase the buying power of individuals.
The Wisconsin Alliance for Women’s Health appreciates HHS’ first steps towards rules for Health Insurance Exchange but looks forward to further consideration of the need for consumer protections. A Health Insurance Exchange needs to be more than a portal, more than a tool for Insurance Providers to access their customers. It must be a tool for consumers to use so that their voice is heard louder and their dollar is able to go further.