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Health Insurance Exchanges

A health insurance exchange is a set of state-regulated and standardized health care plans, from which individuals may purchase health insurance that is eligible for Federal subsidies. In the United States, it is the main thrust of the Patient Protection and Affordable Care Act.

President Obama stated that it should be;

“…a market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that’s best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs. I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”

However, the public health insurance option was ultimately dropped from the reform legislation; the insurance sold on the health insurance exchange in the United States will therefore now be exclusively from the private insurers.

It is left to the states to determine how their own exchanges will be handled.  In Illinois there are two plans currently being formulated, the one that has seen the most activity is House Bill 1577.  The ICS however leaning more towards Senate Bill 1729 which is being put forward by the Department of Insurance.  The intent of both bills is to set up committees to discuss and plan how Illinois will devise it’s own exchange.  HB1577 has the support of many prominent legislators as well as the business community, but thanks to the ICS and other health care groups SB1729 is the only one to actually put health care providers on the formative committees.

We believe it is crucial that health care providers have a voice in creation of Illinois’ health insurance exchange and the ICS will work diligently towards this ends for both our doctors and the citizens of Illinois.  There is a conference call today between the Department of Insurance and many providers (including the ICS).  I would like to thank Dr. John Panopoulos for his help throughout this entire health insurance exchanges process.  He has been involved in most of these conversations since the beginning and has been an invaluable asset to the profession.

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