Diagnosis unknown: Will a health exchange help?

| Print |  Email
Articles - December 2011
Tuesday, November 15, 2011

By Linda Baker

1211_DiagnosisUnknown_02
“We want to design an exchange that is so good people are going to want to be part of it as opposed to being pushed into it,” says Aelea Christofferson, a Bend businesswoman who serves on the Oregon Health Insurance Exchange Board.
// Photo by Randy Johnson

Lurking behind every Oregon small business is a health insurance tale of hardship and woe. At Hawthorne Auto Clinic in Portland, co-owner Jim Houser pays $100,000 annually in premiums to cover his nine full-time employees and their families. That’s about double the amount he paid 10 years ago and 20% of payroll, he says. Aelea Christofferson, owner of ATL Communications in Bend, is locked into a one-size-fits-all plan that compels her older employees to pay the same deductible as her employees with small children. Jose Gonzalez, principal of Tu Casa Real Estate in Salem, has no insurance for himself or the eight agents he employs. “It’s too expensive,” he says simply.

Never-ending rate increases and lack of options are among the reasons why Christofferson, Houser and Gonzalez have high hopes for a new health-insurance program created by the passage of Senate Bill 99 this past June. Scheduled to launch on Jan. 1, 2014, the Oregon Health Insurance Exchange will be an online marketplace where individuals and employers with fewer than 50 employees can shop for health insurance while potentially qualifying for small-business tax credits and individual subsidies. The goal is to create an easy-to-navigate website where consumers can compare health plans on the basis of cost, quality and individual health needs.

“The exchange will be a trusted resource,” says Gonzalez, who, along with Christofferson, is one of three small-business representatives Gov. John Kitzhaber appointed to the 3-month-old Health Insurance Exchange Board. (Houser is a member of the Health Exchange Consumer Advisory Group.) “It will allow me to protect my family and employees.” Other small-business advocates are even more enthusiastic. “To call the exchange transformational is too little a word,” says Ryan Deckert, president of the Oregon Business Association. “It will change the whole way individuals and businesses purchase health care.”

But if anticipation is running high, the challenges — and uncertainties — ahead are significant. The board, which is crafting a business plan for the exchange, due February 2012, must also resolve a variety of complex policy issues, ranging from types of insurance plans and rates to the construction of a consumer-friendly website. At stake is more than the design of a system that will appeal to small businesses and insurance companies alike. A bigger question is whether the exchange, which is less an overhaul of a broken system than an incremental market-based reform, can actually make a dent in the affordability and accessibility of health care — especially in Oregon, which already has one of the most competitive small-group insurance markets in the country.

“The long-term goal is to leverage the purchasing power of the exchange to help improve health-care quality and outcomes, which will eventually impact cost,” says Rocky King, executive director of the Oregon Health Insurance Exchange, a public corporation. If the exchange fails to accomplish this broader task, says King, its impact will be limited. “It will be nothing more than a market aggregator.”

1211_DiagnosisUnknown_Chart01

1211_DiagnosisUnknown_Chart02

1211_DiagnosisUnknown_Graph01



 

More Articles

Shades of Gray

May 2015
Monday, April 27, 2015
BY KIM MOORE

Are we too quick to diagnose corruption?


Read more...

Downtime with the director of Barley's Angels

May 2015
Monday, April 27, 2015
BY JACOB PALMER

Live, Work, Play with Christine Jump.


Read more...

Knight Cancer Challenge No Biotech Dream

May 2015
Monday, April 27, 2015
BY JOE CORTRIGHT

The Knight challenge is an important instance of philanthropy. But we should not assume it will magically transform OHSU into a business- and job-spinning engine for the local economy.


Read more...

Photo Log: The 2015 100 Best Green Workplaces in Oregon

The Latest
Wednesday, May 27, 2015
greenthumbPHOTOS BY JASON E. KAPLAN

Oregon Business celebrated the 100 Best Green Workplaces with an awards luncheon yesterday at the Nines Hotel in downtown Portland.


Read more...

Much ado about data-driven organizations, for good reason

Contributed Blogs
Monday, April 13, 2015
bigdatathumbBY GRANT KIRBY | OP-ED CONTRIBUTOR

The mega-shift from technology-driven to data-driven organizations raises questions about Oregon’s workforce preparedness.


Read more...

Nine lives

Linda Baker
Friday, May 22, 2015
0f4f7bfBY LINDA BAKER | EDITOR

Roy Kaufmann always lands on his feet.


Read more...

Intrepid reporter checks out ZoomCare rebrand

The Latest
Wednesday, May 27, 2015
dentistthumbPHOTOS BY JASON E. KAPLAN

Like all good journalists, OB editorial staff typically eschew freebies. But health care costs being what they are, digital news editor Jacob Palmer couldn't resist ZoomCare's offer of a three-in-one (cleaning, exam, whitening) dental office visit, guaranteed to take no more than 57 minutes. 


Read more...
Oregon Business magazinetitle-sponsored-links-02
SPONSORED LINKS