Health Exchanges, what the hey?

     So what are these Health Exchanges we hear so much about?  They are the cornerstone of the whole plan so it is important to understand what they are and what they do.  Essentially they are individual markets where folks and businesses can shop for health insurance, sort of like a Quickie Mart for health care.  You have to buy this insurance either individually or through your employer or you will be beaten, flogged and forced to watch reruns of Three’s Company.  Okay, maybe not that bad, but you will be fined.  There are some other differences. Some folks will be given money to buy their insurance by the government (kind of like Washington giving you some bucks to buy Twinkies at the Quickie Mart) and second, the government will regulate what insurance is sold in these exchanges (like Mayor Bloomberg saying you can’t buy at Big Gulp at Quickie Mart because the government has determined it is evil).

     The original intention was for each state to provide an exchange (think of it as GeorgiaMart, TennesseeMart, OklahomaMart,etc); however, many states, about half so far, have said “Whoa Nellie! We don’t want to do this ourselves and be subject to further cost and regulation (mainly with the Medicaid aspect) so we are going to take our marbles and go home.” In this instance, the Federalies will run the state exchange, so you will have one, but it may be run by either your state or Washington. 

     Alaska Governor Sean Parnell said that “allocating state dollars and personnel to design and implement an exchange is the most expensive option.” In other words, he wants Washington to pick up the full cost for its creation and operation.
(Obama Care Survival Guide)

     So the bottom line with these exchanges is that if you get insurance from your employer and they continue to provide it, you won’t have to deal with the exchanges.  If they stop providing insurance, or you are unemployed, or you are on Medicaid, or you are employed but your company doesn’t provide insurance as a benefit you will need to get your insurance from the many different flavors offered by an exchange.  Next time we’ll talk about the good and the bad of exchanges.