EDITORIAL: Health exchanges

By NEMS Daily Journal

Legislature works toward better coverage for many
The Mississippi House’s decisive passage on Monday of a law creating a state health insurance exchange could become a major asset bringing more people under an umbrella of health-care coverage, an entirely positive concept for health care in the short and long term.
Gov. Haley Barbour is among the backers of the idea in Mississippi, and he proposes a $1.5 million budget to start an exchange. Insurance Commissioner Mike Chaney has said the federal government, under provisions of the Affordable Care Act, the health care reform legislation Congress passed last year.
The idea does not originate with the controversial new law, but it does require that exchanges be set up and in operation before the 2014 full implementation of the legislation.
Exchanges, however, can operate with a measure of independence from the Affordable Care Act if states set them up, which is one of the reasons Barbour and some other Republicans back Mississippi moving ahead.
The general attractiveness is that exchanges can make health insurance affordable for more people, especially through group plans structured by the private sector and offered by small businesses that don’t have plans now.
The Kaiser Family Foundation’s information service, which specializes in health care, said health exchanges generally “would envision that people without access to employer-sponsored insurance or a public plan like Medicaid could obtain coverage through an exchange. This would include people now buying insurance on their own (like the self-employed), as well as people receiving income-related subsidies. The exchange could be the exclusive place where people buying insurance themselves get coverage, or an outside non-group market could continue to exist. Some proposals would also permit workers with access to employer coverage to join the exchange, or give employers the choice of buying insurance through the exchange.”
Kaiser reported in 2009 that “consumers and employers … may feel a greater sense of ownership with an exchange representing their region. Negotiations with health plans might be more effective at the local level …”
The Mississippi House plan and separate legislation in the Senate both generally address those goals, but the governing board is different in the two bills, a matter that could be worked out in conference.
Kaiser experts concluded that the “idea of a health insurance exchange holds great appeal to a broad range of policymakers and interest groups, in part because they have different notions in mind of what an exchange is and what it would do. …”
A carefully designed exchange could be a boon to health in Mississippi. We hope the Legislature works out a strong and affordable range of options.