Health insurance marketplace
[5] Private non-ACA health care exchanges also exist in many states, responsible for enrolling 3 million people.
[6] These exchanges predate the Affordable Care Act and facilitate insurance plans for employees of small and medium size businesses.
An ideal exchange promotes insurance transparency and accountability, facilitates increased enrollment and delivery of subsidies, and helps spread risk to ensure that the costs associated with expensive medical treatments are shared more broadly across large groups of people, rather than spread across just a few beneficiaries.
[7][better source needed] Health exchanges first emerged in the private sector in the early 1980s, and they used computer networking to integrate claims management, eligibility verification, and inter-carrier payments.
These became popular in some regions as a way for small and medium-sized businesses to pool their purchasing power into larger groups, reducing cost.
An additional advantage was the ability of small businesses to offer a range of plans to employees, allowing them to compete with larger corporations.
I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans.
This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.
"[10] Although the House of Representatives had sought a single national exchange as well as a public option, the Patient Protection and Affordable Care Act (ACA) as passed used state-based exchanges, and the public option was ultimately dropped from the bill after it did not win filibuster-proof support in the Senate.
[12][13] In the first year of operation, open enrollment on the exchanges ran from October 1, 2013, to March 31, 2014, and insurance plans purchased by December 15, 2013, began coverage on January 1, 2014.
Advocates claim these exchanges make these "markets" more efficient, providing oversight and structure, arguing that previous health insurance markets in the United States are poorly-organized and deal with wide variations in coverages and requirements among different companies, employers, and policies.
[34] The subsidies for insurance premiums are given to individuals who buy a plan from an exchange and have a household income between 133% and 400% of the poverty line.
[50][56][57][58] Section 1401(36B) of PPACA explains that each subsidy will be provided as an advanceable, refundable tax credit[59] and gives a formula for its calculation:[60] Except as provided in clause (ii), the applicable percentage with respect to any taxpayer for any taxable year is equal to 2.8 percent, increased by the number of percentage points (not greater than 7) which bears the same ratio to 7 percentage points as the taxpayer's household income for the taxable year in excess of 100 percent of the poverty line for a family of the size involved, bears to an amount equal to 200 percent of the poverty line for a family of the size involved.
[clarification needed][82] Proponents of health care reform believe that allowing comparable plans to compete for consumer business in one convenient location will drive prices down.
Having a centralized location increases consumer knowledge of the market and allows for greater conformation to perfect competition.
As of February, 2015, $268 was the average monthly tax credit for people who qualify for financial assistance in 37 states using HealthcCare.gov through January 30.
[75] Figures from the House Committee on Energy and Commerce would indicate that approximately 1 million high-risk individuals will pursue insurance in the health benefits exchanges.
[87] Thus the high-risk individuals do not number in high enough quantities to increase the net risk per person from previous practice.
They are designed to help consumers find plans personalized to their specific health conditions, preferred doctor/hospital networks, and budget.
[citation needed] The largest and most successful[peacock prose] private health care exchange is CaliforniaChoice, established by CHOICE Administrators in 1996.
The exchange product became the basis for inter-carrier claims settlement between commercial insurance carriers and Blue Cross organizations.
