Health Insurance Exchanges Being Created In Other States

It looks like the change is coming – a change to how consumers buy their health insurance, by getting it at a health insurance exchange.

It looks like changes to the health care system, in the form of health insurance exchanges, are beginning to come to fruition. Witness the State of Vermont, which just recently voted to set up an exchange; the first step to eventually having a single payer program. While it does not go whole hog and propose a single payer system – yet – you can certainly see the writing on the wall.

Right now, the bill they are working with instructs the state to set up a health benefits exchange, as mandated by the Affordable Care Act. This needs to be up and running before any further steps are implemented. In other words, they want to make sure the exchange is in place and working properly, before the state asks the feds to grant a waiver to set up a single payer system.

Since the waiver will not likely be submitted until about 2017, you can pretty much count on the political landscape changing several times over between now and then, both in Vermont and federally. Right now, this is a foot in the water to test the temperature and see how things go. This forward thinking move is being watched with an eagle eye by those who are pro having a single payer system.

Is this a hard thing to set up? Judging by some of the things you read these days, you would think you were pulling hen’s teeth to get cooperation and get states to take the initiative to move forward with health care reform. But then, health care reform has always been a hot button issue, and it remains that way. Certainly this issue is not without supporters, both for and against, much like Vermont has discovered.

There seems to be words on both sides of the fence. Single payer proponents think the methods to control costs are not clear and not strong enough to be effective. They also are not that happy with the bill letting private insurance companies bid on pieces of the administration of the exchange. Come to think of it, that may cause a lot of confusion. There are other things that people have their dander up about, but it mostly all boils down to how the exchange will be budgeted.

One other concern that raised eyebrows is the language of the bill, specifically, that the bill talks about covering “all residents” and not just citizens of Vermont. This is likely something that would need to be clarified either prior to the implementation of the bill or possibly later, in court, should a dispute arise about who is covered under the health exchange. Needless to say, this is a first, and it may just pave the way for the rest of the nation to start setting up its own health insurance exchanges.

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