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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.
Monday, July 13, 2015
BY JACOB PALMER
Dean of the Atkinson Graduate School of Management, Willamette University
Monday, July 13, 2015
BY CHRIS NOBLE
Whether you're stepping out to work or onto the track, Pacific Northwest shoe companies have you covered.
Friday, July 10, 2015
BY LINDA BAKER
Market of Choice is on a tear. In 2012 the 35-year-old Eugene-based grocery chain opened a central kitchen/distribution center in its hometown. The market opened a third Portland store in the Cedar Mill neighborhood this year; a Bend outpost broke ground in March. A fourth Portland location is slated for the inner southeast “LOCA” development, a mixed-use project featuring condos and retail. Revenues in 2014 were $175 million, a double-digit increase over 2013. CEO Rick Wright discusses growth, market trends and how he keeps new “foodie” grocery clerks happy.
Thursday, August 20, 2015
BY DAN COOK
The state’s angel investing fund gets hammered in Salem.
Monday, August 03, 2015
BY KIM MOORE | RESEARCH EDITOR
Pushing the extreme.
Monday, July 13, 2015
BY AMY MILSHTEIN | PHOTOS BY JASON E. KAPLAN
Telemedicine, new partnerships and real estate diversification make health care more accessible in rural Oregon.
Monday, July 13, 2015
BY KIM MOORE
Revenues in Oregon's private, for profit sector maintained solid growth as the economy continued to rebound.
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Attendance, breakfast buffet, materials, certificate of attendance and parking are all complimentary on behalf of the firm.
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