Health Insurers Get Ready For Insurance Exchanges, But Exchanges May Not Be Ready

Insurance Premiums Big Unknown

Premiums are a big unknown.

Without experience in covering millions who had previously been out of the market, some analysts expect carriers to play it safe with relatively high prices. That makes coverage less affordable.

“Private sector health plans are probably going to be pricing fairly conservatively for the first year, maybe for the first couple of years,” the investment analyst Carroll said.

But the biggest question is whether many states will be ready to offer exchange plans at any price.

The first open enrollment season is supposed to run from October 2013 through March 2014, with the first coverage starting 1 January 2014.

States are shopping for which benefits to put in their health care coverage baskets.

If Democrats keep control of the White House and Senate in the November elections, thus ensuring survival of the health care aw, many states are expected to start implementing it.

The states have until mid-November to submit exchange plans to the Department of Health and Human Services. But by then there may not be time to set them up.

“Given the regulatory variation from state to state —and many states have not yet formalized their exchange models —we have not yet made any decisions about where we will be offering our health plans through the exchanges,” said Daryl Richard, a spokesman for UnitedHealthcare, the country’s biggest private health insurer.

“We don’t have the rules of the road we need to make those kinds of public pronouncements” on what plans will be offered where, said Cigna spokesman Joseph Mondy.

Nor do many have confidence thatthe Department of Health and Human Services, which is responsible for setting up exchanges if states balk, will come to the rescue.

“There are huge, huge issues here,” said Robert Laszewski, a consultant and former insurance executive who believes at least 35 states won’t be able to open exchanges on their own on time. “I’m wondering how the government is going to be building 35 exchanges in 35 states to be ready on Oct. 1. And they’re not telling us how they’re going to be ready.”

Insurers still seem optimistic that a coverage mandate for most people and billions in federal subsidies to help pay the bill will eventually generate large new books of business.

“There is a degree of uncertainty,” said Blue Cross North Carolina’s Parkerson.

But, he added: “You can never go wrong understanding your customer and engaging your customer. So we start with the customer and work backward.”

They just don’t know what that path will look like or how long it will be.

This story was produced in collaboration with The Atlantic.

http://www.kaiserhealthnews.org/Stories/2012/October/05/insurance-industry-health-law-exchanges.aspx

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