"Another Model for Health Care Reform"
Americans love having options. From the food we eat to the cars we drive, we relish making our own choices based on our preferences and what is best for ourselves and our families. Health care should not be an exception. Yet the proposals put forward by the Obama administration and the Democratic congressional leadership would create a massive government plan for health care and crowd out the choices Americans expect.
A federal government takeover of our nation's health care will limit, if not eliminate, an individual's options in insurance and delivery. That does not mean "no" is the answer to reform, either. Texas leads the nation in the number of uninsured, which raises the premiums and property taxes for those who are covered. And many families who want insurance do not have access to affordable choices. Now is the time for other approaches. And states can play an important role.
Fortunately, there are promising market-driven, consumer-directed solutions to health reform that beg a closer look. One such innovation is the health exchange.
Under the current system, most employees are presented limited options regarding their coverage - and their choice is to take it or leave it. However, the health exchange places all the decision-making power into the hands of the consumer. A state-level health exchange would allow consumers to compare plans at a single shopping point. Just as many travel Web sites are a commercial compendium for multiple airlines, a health exchange is an online marketplace for health insurance coverage options. Plan information is presented in a standard format, and consumers can complete an electronic application and enroll online. A hallmark of a health exchange is that it utilizes minimum government input and maximizes private competition and consumer choice.
The benefits to consumers are clear. Participation is elective, and employees can choose the coverage that best meets their needs. Their premium contributions are made with pre-tax dollars if they are part of a company unit. Workers who do not qualify for employer-sponsored health coverage, such as part-time or contract employees, could be eligible to receive an employer contribution toward their health insurance. The employer's set contribution would be applied to the premium cost, and the employee would pay the difference.
A health exchange would streamline coverage for families with both spouses employed by allowing contributions from multiple employers to be pooled and applied to a single insurance plan that is best for their household. It could eliminate gaps in care because plan benefits are portable from job to job, provided that both employers participate in the exchange.
The approach is also profitable for employers. A defined contribution system dramatically simplifies their role in health care coverage, reducing an employer's responsibility to setting the contribution rate for its staff. The approach would cut administrative costs and labor, as employers would no longer face the cumbersome task of selecting benefit structures, insurance companies or provider networks, and negotiating a single plan that works for all of their employees. Additionally, making a contribution instead of paying a defined benefit allows employers to plan for future costs and budget accordingly.
Health exchanges make sense for American businesses and workers, as well as for the U.S. health care system. According to the Heritage Foundation, "State-level health insurance exchanges would increase health insurance coverage, significantly lower prices in the individual coverage market ... and increase employers' flexibility in offering health benefits."
The state of Utah has experienced early success in implementing an exchange, which has provided enrollment options that are best for its citizens. The health exchange allows states to incorporate and build on private solutions, and facilitate consumer choice based on price transparency, not government regulation and control. And as consumers are given the opportunity to make informed choices, competition will increase, which results in lower consumer cost and simplified offerings - eliminating the need for a government option or coops.
The health exchange is a valuable model for Texas to follow. It keeps the government in its appropriate role of facilitating innovative private market solutions. And it places the decision-making power exactly where it should be - in consumers' capable hands.