Silicon Investor (SI) -- The First Internet Community

STOCKTALK

We've detected that you're using an ad content blocking browser plug-in or feature. Ads provide a critical source of revenue to the continued operation of Silicon Investor. We ask that you disable ad blocking while on Silicon Investor in the best interests of our community. If you are not using an ad blocker but are still receiving this message, make sure your browser's tracking protection is set to the 'standard' level.

Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (9564)	9/16/2009 12:11:49 PM
From: Lane3	Read Replies (2) \| Respond to of 42652

From the NYT: Explaining the ‘Exchange’: A Primer By David M. Herszenhorn At the core of the proposal to revamp the nation’s health care system is the creation of a government-regulated marketplace. On such an exchange, consumers would be able to shop for insurance, compare benefits and prices, and choose a plan that best suits their needs. Most of the plans offered on the exchange would be issued by private insurers that meet strict government requirements, including minimum benefits packages, levels of allowed cost-sharing through co-payments and deductibles, and overall premium prices — to name just a few basics. The exchange would also potentially offer insurance plans through private, nonprofit insurance cooperatives, which are part of a bipartisan proposal in the Senate. Or the exchange’s offerings might include a government-run “public” insurance plan, which is favored by many Democrats, including President Obama. The majority of Americans shopping for insurance on the exchange would qualify for new government subsidies to help make insurance affordable for individuals and families. But some relatively well-off people shopping on the exchange, like some small-business owners, might pay full freight. In other words, simply being eligible to buy insurance through the exchange does not mean an individual or family automatically qualifies for government subsidies to defray the cost. The question of who gets to shop on the exchange has become highly politicized. As part of an effort to show that illegal immigrants would not benefit from an insurance overhaul, the White House and leading Senate Democrats have said that illegal immigrants would be barred from participating in the new exchange even if they can afford to pay the full cost of insurance. The White House and Democrats say that verification of immigration status will be required to buy insurance through the exchange. And they say that subsidies or not, consumers shopping in the exchange would experience several inherent benefits, which they do not want to provide to illegal immigrants. For instance, the proposal assumes that competition among insurers will be intense and that the number of people shopping for plans will be large — two factors that are expected to drive down the cost of coverage on the exchange. In addition, shopping in the exchange would give consumers access to plans that the government has determined conform to criteria established in whatever health care bill is ultimately approved by Congress. According to the proposals under discussion, insurers, for instance, will be able to vary the cost of premiums on the basis of only a few factors — like age, tobacco use and whether the coverage was for an individual, couple or family. The plans will also have to meet basic minimum standards in terms of covered medical services, including treatment aimed at prevention and wellness. The exchange will also require insurers to describe their plans in virtually identical language, to make it easier for consumers to compare plans. Many details, of course, remain to be decided. Still up for grabs is the question of whether plans offered through the exchange will be national in scope, with a network of providers that includes doctors and hospitals in every state, or whether plans might be restricted to individual states or regions. Perhaps the closest example of what such an exchange might look like is the Web site that provides detailed information about the insurance plans available to federal employees. You can also jump directly to the plan search and comparison tool. Be sure to check the box to include national plans in your search and to search for plans in your zip code. Keep in mind that some of the requirements under consideration in the health care debate in Congress do not yet apply to the insurers currently offering plans to federal employees. In theory, comparing plans on the proposed exchange is supposed to be even easier than comparing existing plans offered to federal workers. If and when a government-regulated exchange is created, it is unclear what — if any — insurance market would still exist outside the exchange. The White House has said that illegal immigrants would have to buy coverage in whatever remains of this “nonexchange” market. In any case, laws that require hospitals to provide emergency care regardless of immigration status are not supposed to change. And the federal government would continue to reimburse hospitals for that care, a cost that now runs to $250 million a year.