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White House official: 'The exchanges will open to more and more people'

On a conference call earlier today, the union representatives mentioned that the exchanges would open to collective bargaining units and Taft-Hartley plans in 2017. This is, potentially, a very big deal. But details are hard to come by. Does it mean that the exchanges open up to all employers in 2017? A later conference call with White House officials saw repeated questions on this front (including one from me), and a studied vagueness: "We're working very hard on the exchanges," they said. But there was a clue to the direction the bill is moving: "Over time, the exchanges will open to more and more people," said one of the officials on the call.

Union officials seem pretty sure that collective bargaining units of all sizes will be included in the exchanges in 2017. That's part of the excise tax deal, in their mind. If they can get a better deal in the exchanges, which have all sorts of plans and a much larger risk pool, then they should be able to go get that deal rather than sticking with pricier insurance that's vulnerable to the new tax.

They're right about that, and this is exactly the sort of movement toward a more competitive, price-conscious insurance market that the excise tax is designed to encourage. The question is whether this deal applies to all employers. Sources briefed on the conversations believes that it does. And if the combination of the excise tax and union concerns with the vulnerabilities of the employer-based market lead Congress to open the exchanges to everyone in 2017, then this has been a successful negotiating process indeed, and this bill is a lot better than it was a week ago.

Related: The importance of the exchanges.

By Ezra Klein  |  January 14, 2010; 6:08 PM ET
Categories:  Health Reform  
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Comments

Interesting, positive development.

I'd suggest that the eligibility of union workers to have exchange plans could be a significant development. It could serve as a model of transferring from employer-based health care to exchange-based health care. Once that transfer has occurred, shifting the employer health benefit to cash compensation is a simpler proposition. As Wyden has noted, getting to a competitive, well-regulated health insurance market where people make their own choices is one of the most critical elements for sustainable cost control in the long-run.

Posted by: wisewon | January 14, 2010 6:33 PM | Report abuse

"If they can get a better deal in the exchanges, which have all sorts of plans and a much larger risk pool, then they should be able to go get that deal rather than sticking with pricier insurance that's vulnerable to the new tax."

The alternative for employees will be to give up their tax-free plans to purchase coverage on their own with after-tax money? Under those circumstances, employer-paid benefits will always offer individuals more for less.

Posted by: Athena_news | January 14, 2010 6:41 PM | Report abuse

"...Congress to open the exchanges to everyone in 2017, then this has been a successful negotiating process indeed, and this bill is a lot better than it was a week ago."

Yes, Ezra; you are right. Looks like the vibes are coming good form WH. Of course devil is in the details and there is still a long way to go to close many more open issues (abortion?).

Posted by: umesh409 | January 14, 2010 7:34 PM | Report abuse

I don't get why this is "a lot better" than what we had. The Senate bill (page 159 in Reid's mark) says insurers can offer plans to large groups on the exchange beginning in 2017. Prediction: few will do so.

Posted by: bmull | January 14, 2010 7:56 PM | Report abuse

"Union officials seem pretty sure that collective bargaining units of all sizes will be included in the exchanges in 2017. That's part of the excise tax deal, in their mind. If they can get a better deal in the exchanges, which have all sorts of plans and a much larger risk pool, then they should be able to go get that deal rather than sticking with pricier insurance that's vulnerable to the new tax."

Finally. They'd better get that deal. It's the only way the excise tax starts to make any sense at all. Put a public option in there and your getting somewhere.

Posted by: eRobin1 | January 14, 2010 10:40 PM | Report abuse

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