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|Articles - December 2011|
|Tuesday, November 15, 2011|
Page 2 of 3
Oregon isn’t the only state restructuring the way individuals and businesses buy health insurance. In 2010, Congress passed the Affordable Care Act, which requires everyone to purchase insurance in 2014 or face a penalty. The federal law also requires states to set up health-insurance exchanges, or have the federal government do it for them. So far, around 12 states have passed legislation creating online marketplaces; Massachusetts and Utah already had such marketplaces in place before passage of the federal law. Forward movement notwithstanding, opposition to national health care reform is one of the challenges facing the exchange initiatives. Along with the National Federation of Independent Business, 26 states have brought a lawsuit against the federal government calling for the Affordable Care Act to be struck down. That case is now awaiting a hearing by the Supreme Court.
In Oregon, the federal government is still on track to pay for all the exchange development costs and the first year of operation. Although many details have yet to be hashed out, some of the goals are relatively straightforward: expand health insurance coverage by targeting groups that typically find coverage out of reach, including small businesses and individuals making up to 400% of poverty-level income. Then sweeten the pot by offering more choice and federal subsidies: specifically, a small-business premium tax credit of up to 50% of a business’ share of its employees’ premium, available to employers with an average employee wage below $50,000. Insurers will be required to offer a set of essential benefits, standardized and rated across carriers so people could compare apples-to-apples cost, quality and benefits. Plans will also be offered at four different levels of coverage, with a “platinum” plan covering a higher percentage of a particular benefit — a hospital stay, for example — than a “bronze” plan.
For their part, small employers will no longer be forced to buy a one-size-fits-all plan for their employees, whose insurance needs vary depending on age, health and family status. Instead, employees would likely be given a fixed contribution, so that “people can go online and choose insurance that’s best for them,” Christofferson says, using a common descriptor. “It will be the Travelocity of health care,” she says.
George Brown, CEO of Legacy Health System and an exchange board member, puts the program in broader perspective. The online marketplace will bring together like-minded small employers, giving them the purchasing clout — and larger risk pool — of a Nike or Intel. “The exchange allows parties to come together to barter their way toward what’s going to be bought and what’s going to be sold, with the oversight of state government to make sure standards are going to be met,” says Brown.
It’s an ambitious vision. More than a web portal, the exchange, so proponents claim, will be a market driver that leverages the power of hundreds of thousands of freshly insured individuals and employees of small businesses. But there’s a catch — or several of them. Far from being a single-payer system, the new marketplace depends on the participation of willing sellers — insurance carriers — as much as buyers. And two years before the exchange opens for business, these interests are not always aligned.
Nevertheless, says Tom Holt, director of legislative and regulatory affairs at Regence BlueCross BlueShield of Oregon, big questions remain about “how to assess the risk and therefore how to price the products.”
Holt and other insurance representatives tick off a list of other concerns: the diminished role of insurance brokers in an online marketplace, developing the information technology to administer premiums for different employees, and the challenge of attracting consumers to the exchange given the relatively benign penalty — about $600 — of not complying with the federal insurance mandate.
Thursday, June 26, 2014
Wednesday, July 09, 2014
BY LINDA BAKER | OB EDITOR
Scott Kveton, the CEO of Urban Airship is taking a leave of absence from the company. As the story continues to unfold, here’s our perspective on a few of the key players.
Friday, July 18, 2014
BY JASON NORRIS | OB GUEST CONTRIBUTOR
Back in May, we shared a common Wall Street quote about investing, “Sell in May and go away.” Fast forward to July and the most common question we have been getting from clients is, “When is the market pullback going to occur?”
Tuesday, July 08, 2014
BY LINDA BAKER | OB EDITOR
The New Yorker recently published a sharply worded critique of “disruptive innovation,” one of the most widely cited theories in the business world today. The article raises questions about the descriptive value of disruption and innovation — whether the terms are mere buzzwords or actually explain today's extraordinarily complex and fast changing business environment.
Update: We caught up with Portland's Thomas Thurston, who shared his data driven take on the disruption controversy.
Monday, July 07, 2014
BY TOM COX | OB BLOGGER
Named after the 2010 experiment by Thomas Ryan, "Robin Sages" are fake social media profiles designed to encourage linking and divulging valuable information.
Friday, June 06, 2014
BY KATIE AUSBURGER | OB GUEST CONTRIBUTOR
How to build a hipster-friendly work environment.
Thursday, June 19, 2014
BY MONICA ENAND | GUEST CONTRIBUTOR
Nine tips for building habits among employees to respond when needed.
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