As Nebraska gears up for planning and creating a health insurance exchange as required by the Patient Protection and Affordable Care Act (ACA), nine Nebraska advocacy organizations representing consumer interests put forward a set of principles designed to help guide the conversation that will take place among legislators and state officials in the coming months.
The Affordable Care Act requires that each state have a health insurance exchange up and running by January 1, 2014. While the federal government will establish initial guidance on the creation of the exchange, states have a significant amount of flexibility to determine how the exchanges should be governed, what benefits will be included, and how consumers will interact with their insurers and their products. The Affordable Care Act was passed to protect consumers and assure that they have access to quality, affordable health coverage. Consequently, this is a perfect opportunity for advocacy organizations representing consumer interests, such as those that co-sponsored this list of principles, to frame the discussion moving forward around consumer interests.
Health insurance exchanges are designed to serve as a place where individuals and businesses can shop for coverage with the help of easy-to-understand information on all their options. Plans sold through exchanges will have to meet certain standards so that consumers get good value for their money. The exchanges will serve an important purpose for people who are middle- or low-income: They will be the place where people can purchase insurance with the tax credits that the Affordable Care Act provides to make coverage affordable for all Americans. In addition, when individuals who are eligible for Medicaid or other public coverage programs enter the exchange, they will quickly and smoothly be directed to the correct program.
However, given the flexibility that states have in crafting the exchange, this will only be possible if the right choices are made going forward. The set of principles released by Nebraska’s consumer advocates sets out to ensure that exchanges function as intended: as marketplaces for high-value coverage that are user-friendly, transparent, and stable.
The principles outlined in the document focus on the following:
- Transparency and coordination of the exchange planning process.
- A “No Wrong Door” structure where individuals can use a single application to access public benefits or private insurance.
- Avoiding conflicts of interest among those that will oversee the exchange.
- The important role of navigators in educating consumers and facilitating enrollment in coverage.
- Ensuring access to quality products that provide real value for Nebraskans’ premium dollars.
- Preventing adverse selection in health plans (i.e., “cherry picking”).
The groups releasing the report include:
- AARP
- American Cancer Society Cancer Action Network
- Center for Rural Affairs
- National Alliance on Mental Illness, Nebraska Chapter
- National Association of Social Workers, Nebraska Chapter
- Nebraska Appleseed
- Nebraska Farmers Union
- Public Health Association of Nebraska
- Voices for Children in Nebraska
The set of principles can be found here