Mandatory Health Insurance: How Will It Affect You?

Mandatory Health Insurance: How Will It Affect You?

Dozens of Rhode Islanders spent their Friday morning getting a crash course on how they will be affected by the creation of a mandatory health insurance exchange that will be fully operational by 2014, as required by President Obama’s Affordable Care Act.

South County Hospital CEO Lou Giancola and Nick Tsiongas, the founding chair of the HealthRIght board, were the featured speakers and facilitators of what became an open forum where attendees discussed the role of a health insurance exchange in health care reform.

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The federally mandated health insurance exchange is essentially a one-stop shop for individuals, families and small businesses to purchase affordable health insurance.  If the state can’t move forward on creating a plan on its own, something Teresa Paiva Weed proposed in January, the federal government would step in and implement it by 2014.

Nobody Is Happy with What’s Happening

Dr. Paul Block, an organizer for Friday’s training, said he was taken aback by the one thing everybody in the room, whether they were individuals or insurance providers, agreed upon: The current system doesn’t work.

“The consensus in the room was that nobody is happy with what’s happening,” Block said. “A health insurance exchange’s purpose is to address it from all the stakeholders’ perspectives.”

Block said that a robust health insurance exchange can be extremely beneficial to residents of the state. He said Vermont has the most robust state system set-up in the country.

According to Giancola and Tsiongas, an ideal exchange would design benefits packages, complete with quality control and payment design, and negotiate terms for customers to provide cost control and maximize the consumer’s purchasing power.

Rhode Island’s Problems

Tsiongas’ group, HealthRIght, is a statewide organization that brings key stakeholders together to address health care reform. Block said the key to the group is that it has voices from all different backgrounds working together to figure what’s best for the state when it comes to the health insurance exchange.

But Giancola says the state is still slipping behind.  During his presentation, he made it clear that too many Rhode Islanders are uninsured and the state lags in controlling care for cost-effectiveness. According to Giancola, the state’s leadership in coverage of citizens is declining, from 6th in overall ranking in 2007 to 11th in 2009.

If the state can’t push forward with a robust exchange, Block said much of the state’s control over required health insurance plans would be limited.  He said potential influence over cost and quality control could be restricted if the state only went with a minimal exchange.

The State’s Current Plan

In January, Senate President Teresa Paiva Weed introduced legislation that would establish an exchange in Rhode Island. Paiva Weed said it would be a centerpiece to the state’s health care reform implementation.

“The exchange will create a health benefit marketplace that is fair, competitive, transparent and understandable to individuals and small businesses,” Paiva Weed said. “It will also have the important job of getting federal subsidies to the people who need them.”

Paiva Weed said the experts on an exchange board would be able to analyze and inform the General Assembly about what is and isn’t working when it comes to healthcare reform in the state.

“The exchange planning grant from the federal government provides Rhode Island with an opportunity to study our marketplace and impact of each decision we make on costs and the marketplace,” she said.