The Murky Effect of Insurance Exchanges
By David S. Hilzenrath
The Lewin Group, which is owned by insurance giant UnitedHealth Group, estimates that almost 100 million Americans would lose the option of obtaining health coverage directly from their employers under a health-care bill proposed by House Democrats.
On the other hand, the Congressional Budget Office says ....
As it turns out, the CBO doesn’t really say.
The CBO sent lawmakers Sunday an analysis of the legislation that appeared to address the issue, and at first glance, it seemed to put the number of affected Americans at 3 million.
But the congressional analysts were was looking at the issue in a different way, rendering its number and Lewin’s widely quoted figures a case of apples and oranges.
When the CBO said that 3 million people would lose employment-based coverage, including dependents of employees, it was defining such coverage as to include insurance subsidized by an employer but obtained through a proposed insurance marketplace, called an exchange.
In other words, the CBO estimate did not count workers who would be forced into the exchange because their employers stopped providing coverage in the conventional sense.
Under the House Democrats’ plan, certain employers would be allowed to move their employees into the exchange, where the employees could choose from public- and private-insurance options. Firms with up to 20 workers would be eligible to participate in the exchange, the legislation says; a new federal overseer would be empowered to decide whether larger firms could eventually participate.
Meanwhile, the legislation would pressure many employees to provide health benefits by requiring them to pay a penalty otherwise. It would give tax credits to certain small businesses to help them provide coverage.
Whether being moved into the exchange would be good or bad for employees is another issue.
President Obama has asserted that, if people like the coverage they have now, they will be able to keep it. And Some workers may be more comfortable with their employer providing health benefits directly, on the theory that their employer is more likely to look out for them, Lewin Group vice president John Sheils said.
But entering the exchange could present more attractive insurance choices, Sheils said. Some of the same health plans available to workers outside the exchange would be available within the exchange, he added.
Lewin has predicted that many people would choose the public plan, largely because it would offer lower premiums. In addition, if the public plan followed the example of Medicare, the federal program for older Americans, it would do less than private plans to restrict patient care, Sheils has said.
Health plans competing within the regulated environment of the exchange would have to comply with an array of consumer protection requirements.
Critics of a public-insurance option have invoked Lewin estimates to argue that creating such an insurance plan could lead to millions of people losing employer-sponsored coverage.
By
David S. Hilzenrath
|
July 28, 2009; 4:45 PM ET
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Posted by: chandler02 | July 30, 2009 4:12 PM | Report abuse
There is a typo in the article. I believe paragraph 9 should read
"Meanwhile, the legislation would pressure many employers to provide health benefits..."
i.e. change "employees" to "employers".
Posted by: mookie1234 | July 30, 2009 8:31 PM | Report abuse
just wake me when i can shove my employees on the exchange and not pay for them anymore. i'm sure the lines for that won't be TOO LONG. ya right.
well at least they'll have qualified personell to help my employees with questions about the exchange, plans and how it works, ie filling out forms etc.
Oh wait? they won't? It'll just be dumb government workers like they have at medicare? that can't even understand that since my father has a company less than 20 employees Medicare is primary and his insurance is secondary??? I've only been trying for several months having spoken to about a dozen people that gave me the wrong answer all the time.
I can't wait until this all flops in their faces. The democrats won't see the light of day for 40 years.
THAT will be their punishment and maybe by then we'll be out of debt.
Posted by: visionbrkr | July 31, 2009 12:57 AM | Report abuse
just wake me when i can shove my employees on the exchange and not pay for them anymore. i'm sure the lines for that won't be TOO LONG. ya right.
well at least they'll have qualified personell to help my employees with questions about the exchange, plans and how it works, ie filling out forms etc.
Oh wait? they won't? It'll just be dumb government workers like they have at medicare? that can't even understand that since my father has a company less than 20 employees Medicare is primary and his insurance is secondary??? I've only been trying for several months having spoken to about a dozen people that gave me the wrong answer all the time.
I can't wait until this all flops in their faces. The democrats won't see the light of day for 40 years.
THAT will be their punishment and maybe by then we'll be out of debt.
Posted by: visionbrkr | July 31, 2009 12:57 AM | Report abuse
I would be just a little suspicious of the numbers of the Lewin Group. It seems since they are owned by United Health Group, that they might have an agenda. How can you compare their numbers to those of the CBO? In fact, I am surprised you would cite them at all. I guess the Republicans have mentioned them as independent so many times that it is really starting to seem like the Lewin Group is independent.
Posted by: ljhyde | July 31, 2009 3:19 AM | Report abuse
ljhyde,
I would agree about Lewin's agenda. The only issue with that is that the Mayo Clinic (who the president PUSHED as the standard) also said that a public option like they're talking about will destroy hospitals and private insurance.
Are they on the "take" too?
I don't think so.
Obviously the WAPO reporter doesn't mention that because it doesn't espouse his agenda.
Posted by: visionbrkr | July 31, 2009 9:01 AM | Report abuse
Donot CRY fom me United Health iInsurance..
just got a BILLION-DOLLAR MILITARY HEALTH -CARE CONTRACT and also AETNA.....Per wall street journal .
Blue Shield of califonia "WON" $ 16 Billion contract...
So lets find Who is Who and Who in congress is covered by ??Yes what Company is covering Congress? Remeber the Old Senator couple years ago ..he work at congress during the day and check himself into the Walter REED hospital every night for over a year?WHO payed that bill?
love to know
Posted by: sigup | July 31, 2009 12:09 PM | Report abuse
If there are all these people who are happy with their employer provided health care, where are they? I haven’t met any.
Last year we paid more than $20,000 for health care coverage (for a family of 3 in good health) and they didn’t pay a single invoice that was sent to them.
Has anyone like the CBO done a study on what is really wrong? Why are costs going up so much?
How can we fix it if we don’t know what is going on?
The only thing I am really sure of is the insurance people are a big part of the problem and so far only an impediment to a solution.
Posted by: biggerjake | July 31, 2009 12:09 PM | Report abuse
Well the Defense Deprt. just awarded the UNITED HEALTH INC. and AETNA
Health contract for $$$$$ BILLION in healthscare and Blue Shield of California $ 16 billion....
So Where did the saving go..for the healthcare bill in congress?
Posted by: sigup | July 31, 2009 12:14 PM | Report abuse
Donot CRY fom me United Health iInsurance..
just got a BILLION-DOLLAR MILITARY HEALTH -CARE CONTRACT and also AETNA.....Per wall street journal .
Blue Shield of califonia "WON" $ 16 Billion contract...
So lets find Who is Who and Who in congress is covered by ??Yes what Company is covering Congress? Remeber the Old Senator couple years ago ..he work at congress during the day and check himself into the Walter REED hospital every night for over a year?WHO payed that bill?
love to know
Posted by: sigup | July 31, 2009 12:09 PM | Report abuse
you dumb tool. don't go acting like they made that in PROFIT. they're insuring and covering our soldiers.
I'll tell you what genius, you go ahead and get off your couch and brush off the cheetos and you design a delivery system.
I've just realized that many of these people on here that are for FREE HEALTHCARE FOR THEM probably aren't working and are lazy slobs that expect everything to be handed to them.
To those that are: you make me sick.
Posted by: visionbrkr | July 31, 2009 11:49 PM | Report abuse
Donot CRY fom me United Health iInsurance..
just got a BILLION-DOLLAR MILITARY HEALTH -CARE CONTRACT and also AETNA.....Per wall street journal .
Blue Shield of califonia "WON" $ 16 Billion contract...
So lets find Who is Who and Who in congress is covered by ??Yes what Company is covering Congress? Remeber the Old Senator couple years ago ..he work at congress during the day and check himself into the Walter REED hospital every night for over a year?WHO payed that bill?
love to know
Posted by: sigup | July 31, 2009 12:09 PM | Report abuse
you dumb tool. don't go acting like they made that in PROFIT. they're insuring and covering our soldiers.
I'll tell you what genius, you go ahead and get off your couch and brush off the cheetos and you design a delivery system.
I've just realized that many of these people on here that are for FREE HEALTHCARE FOR THEM probably aren't working and are lazy slobs that expect everything to be handed to them.
To those that are: you make me sick.
Posted by: visionbrkr | July 31, 2009 11:49 PM | Report abuse
Amidst all the saber rattling and cat calls surrounding the latest legislative argument about the future of healthcare, a small and incredibly disturbing trend that casts a pall on the future of Medicare seems to find its way into every version of the soon to be voted upon – and yet to be written – healthcare bill.
Few would argue that reform is seminal in ensuring that everyone gets the American version of healthcare. But in our zeal to create a state-of-the-art system that provides top of the line care for which no one wants to pay, our lawmakers seem to have made a rather bad decision. They want to cut Medicare by 20% or more.
The result will be a substantive decrease in home care services. The home care agencies of America, whose nurses are frantically providing life preserving and enriching care to Medicare recipients nationwide, are now staring down the business end of a law that would flood already overworked hospital and long-term care staff with an overwhelming deluge of cases, making the Burmese Tsunami of 2008 seem like a kiddy-pool ripple.
Home care is the most cost effective manner of providing care, and study after study proves this as well as the fact that people heal faster at home. Medicare users comprise a considerable portion of the home care patients nationwide, and currently proposed changes are tantamount to shooting missile right through a plane loaded with millions of innocent and disabled passengers. The mere existence of an easy target does not justify its demise.
Let’s not forget that these people, for the most part, paid into the Medicare system for many years on the promise that the insurance would be there should they become disabled or upon retirement. Has our lust for change become so brazen that we are willing to forget these people and our own futures? After all, we will all one day need Medicare.
It is my fervent hope that members of all three branches of our government will stop one moment before the vote and ask themselves this question:
“Will I do that which is politically expedient, or will I do that which is right?”
Edward S. Navis, RN, BS, SPHR
Little Falls, NJ
Posted by: edwardnavis | August 1, 2009 1:13 PM | Report abuse
The comments to this entry are closed.
I think people are becoming confused with the Exchange, and the Public Option. On the Exchange, PRIVATE companies would offer insurance plans that meet certain standards (no rescission, no disqualification for pre-existing conditions, etc.) People moving to the Exchange is not the same as people moving to the Public Option.