Ezra Klein is banging out a great series of article about the new health care bill and how it works. One of them, about insurance exchanges, talks about a piece that will be available to be crafted by states as they see fit. He sees it as the most important feature of the bill.
http://voices.washingtonpost.c…
The bill gives states the option of setting up an exchange for individuals or small business, and allows partnering with other states. In 2017, states can decide to open the exchanges to larger employers.
The exchanges provide a market for competition to take place, and where regulation can be applied. Quality ratings and enrollee satisfaction will be available on each plan for comparison. Klein says, “A state with an ambitious exchange administrator could really do a lot with this provision.”
There are also concerns outlined about the successful implementation of the exchanges. In fact, Klein feels this is a crucial point in this process, going as far as saying that, “success of the exchanges is the difference between health-care expansion and health-care reform”
So now that this is on its way to an Obama signing ceremony, I wonder how our candidates for governor plan to move forward with this component of health care reform?
The problem is that no real competition will take place because the inscos maintained their anti-trust exemption. If congress had managed to do away with that, it could have made an enormous difference in the potential for meaningful cost controls.
Surrender monkeys, yes. I agree that this bill is far from what we need. But do we walk away from what little window of opportunity it provides?
I agree with the claim that Klein has drank the mainstream media kool-aid and is now shilling for the healthcare bill, but he still knows a lot about the workings of the articles of the legislation. If you can separate his over-zealous opinion of the impact it will have, his basic analysis is well worth reading.
I was careful to take only his analysis, not his emotions. The exchanges are an important part of the bill, even if they may not be as effective as he thinks. However, all the claims against exchanges are based on past models and ignore the fact that this will be a new opportunity to establish regulations and baseline coverages on a state by state (or groups of partner states) basis.
Should VT’s next Governor ignore this mechanism? I hope not. I’d love to hear what they think, or ideas from anyone. Is there a place for the exchanges alongside VT’s own reforms and how do they mesh? Are there like-minded states out there that we could partner with under progressive standards to create a critical mass?
This is the most significant part of the bill for state government to consider going forward, what’s the thinking?