National Press Club

More states to establish own health care exchanges, experts predict

February 3, 2014 | By Talia Schmidt | taliaschmidt@gmail.com

As the health care reform law takes effect, states will want to run their own coverage programs, experts said at a Feb. 3 Newsmaker press conference at the National Press Club.

“I think a lot of states will move (from the federally facilitated marketplaces) to state-based exchanges,” said Joel Ario, a managing director at Manatt Health Solutions. He predicts the transition will happen more frequently when more people acknowledge that the Affordable Care Act is a permanent fixture.

Ario was one of the participants from the health care and health insurance industries in an event entitled "Obamacare After the Exchanges."

Once states default to the federal government, they only have a limited amount of time before opting out and creating their own marketplace. After some time, state residents will make peace with the system, Ario said.

“Once you’re under a federal regime like that, it might take a long time to change,” Ario said. “The window might close.”

Ryan Young, senior director of federal government affairs for the Independent Insurance Agents & Brokers of America, said he hopes to see more states move toward running their own marketplaces. He traveled around the country convincing states legislatures that it’s much better policy to design their own health insurance marketplace.

Christina Postolowski, senior policy analyst for Young Invincibles, said that in 2014, more states will expand Medicaid. Ario agreed but added that rather than an increase in traditional Medicaid expansion, there will be an increase in the approval of alternative plans.

Postolowski, who works on outreach and education to help young adults get covered, said that people who make less than $46,000 a year can be eligible for tax credits.

Some fear that the young adult population, which is key to the success of a healthy mix of consumers buying into the system, would rather pay a penalty than purchase insurance. Paying that penalty gives you nothing for your money, but when you buy health insurance, you’re getting coverage, Postolowski said.

Ario also endorsed buying insurance on the exchanges.

“I’ve been a homeowner for 25 years and I’ve never used the insurance I have for my home,” Ario said. “But I’d still rather have it. The reason you buy health insurance is not for day-to-day doctor visits; the reason you get it is, if you ski into a tree or a genetic thing happens to you, you go bankrupt.”

The panel also addressed a proposal by three Republican senators that would repeal the health-care reform law and establish an alternative plan.

Brian Atchinson, president and CEO of the Physician Insurers Association of America (PIAA), warned lawmakers that they must address the needs and concerns of physicians, nurse practitioners and other health care providers.

Introducing millions of new health care consumers into the market puts a strain on physicians and the community of providers, he said.