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Friday, April 16, 2010

Regulated marketplaces will help consumers find affordable care

Kate Blocher

Staff Writer

For those of us not lucky enough to be insured by our employers, having to face the daunting task of navigating the private insurance market can cause heart palpitations. The current insurance market is confusing and overwhelming; there is no one state or federal entity that regulates all markets nor is there much regulation on what information insurers must provide to consumers. Therefore it is often difficult for consumers to know what exactly they are getting under each plan, until it's too late.

As if that wasn't bad enough, many markets are dominated by one or two insurance companies, making it nearly impossible for consumers to find a good deal on insurance, while allowing the dominant companies to continue to charge astronomical premiums.

Lucky for us, the passage of health reform will soon address these problems with the creation of newly regulated marketplaces known as state-based exchanges.

These new marketplaces will provide consumers with information to enable them to choose wisely among different health plans. Premium and cost-sharing subsidies will be available to make coverage more affordable.

Insurers in these marketplaces will be required to provide health plan information in an easy to understand format, online and in other ways, so that consumers will be able to understand and compare plans. The idea is that by encouraging consumers to compare the benefits of all plans before choosing one, insurers will compete for business, ultimately giving consumers better plans at lower prices.

Each exchange will be state-based, but the law allows flexibility in how states chose to run them.

[S]tates with smaller budgets and populations may elect to create a regional exchange that serves the residents of several states.

States are required to have these exchanges up and running by 2014, but many states are starting to lay the groundwork now for their own state exchanges. Massachusetts already has a fully functioning insurance exchange, and

Oregon... recently created the Oregon Health Authority to implement health-care reform legislation

Wisconsin has also gotten the ball rolling, announcing the recent opening of a new Office of Health Care Reform. One of their many tasks will be creating the state's insurance exchange. The state's governor, Jim Doyle "would love to get this exchange up and running as quickly as possible."

And for the millions of Americans who have had to muddle their way through the private market, they too cannot wait for the exchanges to be up and running!