Lifestyle

4 Ways Open Enrollment will Improve Healthcare Exchanges by 2019

4 Ways Open Enrollment will Improve Healthcare Exchanges by 2019
Image credit: PolicyBazaar
Entrepreneur Staff
4 min read

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Despite the concerted efforts of the Republicans to replace and repeal the ACA (Affordable Care Act), the state-based and federal exchanges that it has built would be operational as soon as it’s 2019. The primary aim of these marketplaces is to help small businesses, families, and individuals purchase and enroll in the cost-effective medical insurance.

The American Health Care Act (AHCA) is the possible replacement of Affordable Care Act, and both of these acts are reliant on a common insurance marketing structure particularly to the people who do not have insurance coverage provided by their employers or a different source. In a country like India, employers provide coverage to their employees, in order to make them feel safe and secure in the workplace. The participants are entitled to receive health insurance policy benefits applicable as per the terms of group insurance while they might also have standalone health coverage at the same time. Well, certain decisions are able to reshape the options to be offered in 2019, which are made by Centers for Medicaid Service and Medicare.

The decision makers are urged to consider the following four strategies to ensure better functioning of exchanges:

High-Risk Adjustment

Insurance companies need to sell health insurance plans to individuals applying for coverage at an affordable price without necessitating individuals to provide their medical details. Most insurance companies aim at earning a strong profit and denying individuals for coverage required whenever an individual falls sick. Risk adjustment helps in preventing this from happening going forward, as it shifts money to insurers that cover less healthy individuals from those covering individuals that are comparatively healthy.

To help this, various states must create common resources that insurance companies can scrutinize the health history of the maximum number of individuals anonymously. This, on the other hand, will help insurers set more accurate price for their products.

Making Choices Simple

Insurers, today, make small changes in their networks and various deductibles and are able to offer distinctive plans with a price range. For instance, Vernon County has 41 insurance plans in its Silver category (sets a benchmark for subsidies for its customers), which are available on healthcare.gov and have 36 distinctive benefit designs. This turns out to be confusing. Healthcare.gov needs to insist insurers to offer certain benefit designs that can simplify making choices for consumers to perform a comprehensive comparison and end up buying themselves the best health insurance plan.

Expand Reachability and Marketing

Consumers often find it difficult to get the most accurate and reliable information that is accessible through exchanges. Undoubtedly, various agents and brokers are the only reliable sources of information available to health insurance seekers out there. It’s the noble duty of every insurance broker to provide the most relevant and genuine information to individuals who are new to health insurance domain and have no information of specific terms like Co-insurance and Co-pay. Insurance companies must provide the promised commissions to these brokers.

Marketing strategies and their corresponding implementation can take the competition to a higher level, while it can turn the table upside down too.

Increment in Subsidies

At present, the Affordable Care Act or ACA subsidizes insurance for coverage for those who earn maximum up to 400% of the federal poverty line. A senior citizen married couple earning $64,080, while staying in East Boston Rouge, L.A., is supposed to receive $16,020 as assistance. The cost of the Benchmark Silver Plan is expected to be $6,204. In contrast, the Bronze plan could cost them around $516. However, a couple would have to pay $16,536 for the same Bronze plan, if they earned just one more dollar in their income.

In contrast, individuals who pay the full health insurance premium and either don’t receive or are not eligible for a subsidy are costly to be covered. Congress is expected to increase various subsidies so that more and more people can purchase health cover for themselves. The AHCA has proposed subsidized support for the maximum up to 650% of the federal poverty line. If there are additional subsidies, then more and more individuals are likely to be able to purchase policies and healthy people are expected to enter the market. Resultantly, the premium is likely to go down.

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