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|Articles - December 2011|
|Tuesday, November 15, 2011|
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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, December 18, 2014
BY LINDA BAKER
2014 was a year of wild contradictions, fast-paced growth and unexpected revelations.
Wednesday, October 22, 2014
BY KIM MOORE
A conversation with Majd El-Azma, president and CEO of LifeWise Health Plan of Oregon, followed by the Healthcare Powerlist.
Saturday, December 13, 2014
Seven tidbits about the president and CEO of AKT Group.
Wednesday, October 22, 2014
BY JOE ROJAS-BURKE
Bans on genetically modified crops create uncertainty for farmers.
Friday, November 14, 2014
BY JESSICA RIDGWAY
Oregon entrepreneurs reveal their favorite caffeine hangouts.
Wednesday, November 26, 2014
BY NISHANT BHAJARIA | OP-ED CONTRIBUTOR
By now, anyone who knows about it has a position on President Obama’s executive order on immigration. The executive order is the outcome of failed attempts at getting a bill through the normal legislative process. Both Obama and his predecessor came close, but not close enough since the process broke down multiple times.
Wednesday, October 22, 2014
Peter Lizotte at ACME Business Solutions and Roger Busse at Pacific Continental Bank share their favorite reads.
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|Obama to announce end of Cuba isolation|
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While the Bend City Council ultimately upheld the approval which enables OSU-Cascades to move forward with the 10 acre site, it did also thoughtfully consider the nature of its code requirements, resident concerns and OSU-Cascade’s efforts and suggestions and crafted conditions of approval to address potential impacts of the site in the area.