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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, November 02, 2015
BY LINDA BAKER
The hollowing out of the American city is now a bona fide cultural meme. Newspapers, magazines and digital media sites are publishing story after story about the morphing of urban grit and diversity into bastions of wealth and commodity culture.
Saturday, October 24, 2015
BY JACOB PALMER | DIGITAL NEWS EDITOR
What's it like working with your sister and how do you compete in Portland's crowded artisan ice cream space?
Thursday, November 12, 2015
BY LINDA BAKER
I walked off the Vigor Industrial shipyard that day with a clear cover line in mind: the Love Boat.
Tuesday, October 06, 2015
BY CHRIS NOBLE
As we worked on the October cover, it became evident that Nick Symmonds is a hard man to catch — even when he’s not hotfooting it around a track.
Friday, November 20, 2015
BY JASON NORRIS AND MARY FAULKNER
It’s been a volatile year in equities and heading into the holiday season, it doesn’t look like these market extremes will dissipate.
Wednesday, October 21, 2015
BY JASON NORRIS | CFA
Volatility reigned supreme over the summer. The old Wall Street adage of, “Sell in May and go away,” was prophetic in 2015.
Wednesday, October 28, 2015
BY JACOB PALMER
Live, work, play with the president of Gramor Development.
|The Love Boat|
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|Costco chicken salad linked to E. coli case in Washington|
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|Enormous drugmaker emerges from Pfizer, Allergan deal|
|Startups joining lobbying game|
|Merchants complain as Square goes public|
Economic diversity has proven a smart strategy for the Port of Hood River. How can other Oregon communities replicate the model?
Phone, Internet needs of small community school districts earn attention of top-five telecom provider.
Farmland LP grows its vision for organic farming in Oregon.
The Salem Convention Center has capped its tenth anniversary year by earning the prestigious “Best of the Best 2015” award from NW Meetings & Events magazine. Selected as the Best Convention/Conference Venue in Oregon by meeting and event planners from Alaska, British Columbia, Idaho, Oregon and Washington, the Salem Convention Center ranked above the Oregon Convention Center and the Portland Art Museum.
The Oregon Cooperative Hall of Fame honors individuals for their outstanding contributions to the successful building and operation of Oregon agricultural cooperatives.
Health insurer reports $10.2 million in net income after taxes through the first nine months of 2015.