Healthcare Technology Featured Article

June 14, 2012

Health Insurance Exchanges New Debate Point

Even as the Supreme Court inches toward making a decision on whether the Affordable Care Act (ACA) is constitutional, people are already wondering what effect it will have on their health insurance.

According to a story by Abby Goodnough, one of the major draws of the ACA is the formation of health insurance exchanges, an online marketplace meant to simplify buying insurance and in that way help people find a plan they can afford.

If the Supreme Court does indeed vote yes on President Obama’s federal healthcare law in its decision expected later this month, Goodnough writes that “proponents say that exchanges will be a crucial tool for extending insurance to most Americans.”

Right now, it’s a hodge-podge of often indecipherable plans and choices, different in every state. According to Goodnough, the law requires every state to establish an exchange, but some, like Louisiana and Maine, refuse.

Louisiana has a lot at stake, according to Campbell Robertson in the 2009 New York Times story, which explains how its role under the new law will affect that state’s unique way of caring for the poor – its charity hospitals.

Even if the Supreme Court strikes down the federal mandate requiring all Americans to buy health insurance – the main sticking point of the debate – many people believe some form of exchanges could still be crucial to expanding coverage in a number of states, according to Goodnough.

Many worry that some people may only pay a modest premium or none at all – that, as Goodnough explains, instead of a free marketplace, insurance exchanges will become like an extensive public welfare program.

But some states are moving ahead; Gov. Neil Abercrombie of Hawaii announced today that the state intends to develop a state-based insurance exchange.

See Denise Sikora explain the health insurance territory in the video below. 

The fact remains: buying health insurance is still complex and comparisons very difficult. Larry Wall, chief operations officer at Compass Health Systems, advises getting a policy that does not set a certain fee for different surgical procedures; you just need to pay the doctor. Make sure the day rate for the hospital is reasonable – “$100 per day is not reasonable. $1,000 a day is in the ballpark,” he wrote at

Make sure that prescription coverage is part of the policy as well, and has set co-pay for prescriptions and not a discount for prescriptions. “With the co-pay you know what you are going to pay when walking into the pharmacy,” Wall said.

Edited by Braden Becker

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