5 Things to Know about Obamacare in 2013- Part 2

                 
 

Health Insurance exchanges are good programs

 

A health insurance exchange is a government regulated healthcare plan where individuals may purchase health insurance and be eligible for federal subsidies. This type of exchange is intended to help expansion of insurance coverage to more people, especially those that either cannot afford insurance or are not covered by their employer.

 Because of the recent ruling by the Supreme Court, states may opt out of having to begin these exchanges since the federal government may not exploit the states monetarily by withholding Medicaid funds if the states do not comply. Many states in the South have any opted out such as Texas and Florida and more are anticipated to opt out of this program. Remember, that many employers will either pay a fine for not insuring their employee or reduce a worker’s employment status from full time to part-time so that they are not required to cover the employee's health insurance. The employer will do this simply because the cost of healthcare coverage will be too high to run their business and this will result in many employees needing to join these health insurance exchanges or face individual fines (or as Supreme Court Judge Roberts has determined face additional taxes).

 Many state governors realized that the federal government will regulate the exchanges and initially foot the majority of the bill but that in time the financial obligations will fall on the states without having control of the programs. Therefore, federal government will run the program. The best option of course is for the states to run these exchanges since they can be more fiscally responsible, especially if there is no federal interference. Since the goal of the administration is to eventually have one system of healthcare for everybody, the federal government will not give up that control. Again, the best scenario would be for the states to receive block grants from the federal government and let the individual states take care of their own poor. This would be fiscally more responsible especially since the states, unlike the federal government, have to balance their budget every year.

 These exchanges if run by the federal government will operate in the same manner as the VA, where the cost of care is more important than the quality of care. This will limit choices by individuals and will also affect the type of care each individual patient receives. So, it is my opinion that the states should opt out of these health exchanges and begin lobbying with the majority of governors in individual states to provide health care for their own poor by having Medicaid allocated to the states and given to the states directly with block grants by the federal government. This would take away the control of healthcare from the Big and intrusive federal government. Also, this will result in better healthcare delivery since it is more local. When health insurance exchanges are run by the federal government, it is a formula for disaster with more waste and inefficiency added to the system. This will result in lower quality of care and more harm to the individuals living in that state.

Therefore, health insurance exchanges are not the programs as advertised during the Obamacare legislative debate in early 2010.