Health Insurance Exchanges Essay

Managed care dominates health care in the United States. It is any health care delivery system that combines the functions of health insurance and the actual delivery of care, where costs and utilization of services are controlled by methods such as gatekeeping, case management, and utilization review. Different types of managed care plans came into development by three major factors. These factors include choice of providers, different ways of arranging the delivery of services, and payment and risk sharing. Types of managed care organizations include Health Maintenance Organizations (HMOs) which consist of five common models that differ according to how the HMO is related to the participating physicians, Preferred Provider Organizations

With the creation of the Affordable Care Act under Obama, it was said to be like a Expedia for health insurance however that has not been the case. Marketplaces currently do not have much competition so the original thought of people being able to shop around and compare plans

The affordable care act was passed by congress and then signed into law by the President on March 23, 2010. On June 28th 2012 the Supreme Court rendered a final decision on the law. The affordable care act also known as the health care law offers clear choices for consumers and provides new ways to hold insurance companies accountable.

The Affordable Care Act is an act used to help citizens that need help with medical bills, and is also called Obamacare. The ACA was an act passed by President Obama is 2010 and it is used to help people with health care. People around the United States use ACA for medical bills, and health insurance. Affordable care act is not only to help people with medical bills it also can be used for people who really need help with medical bills and need help financially. The fate of the Affordable Care Act is up in the air because the new president may or may not repeal it.

According to David Nather, the bill also plans to set up something called a health exchange. A health care exchange is a virtual marketplace where you can purchase health insurance. It is “Expedia for health care” essentially(page 71). The exchanges were created for small businesses and for people who cannot obtain employer based insurance or they do not want insurance from their employer. Health insurance cannot refuse coverage for pre-existing conditions. The new standards organize the plans into one of four categories. These categories are as follows: bronze, silver, gold and platinum. According to Nather, bronze covers 60% of all health care costs; silver covers 70% of all costs; gold covers 80% and the platinum plan covers 90% of all health care costs. All these values are averages so coverage will vary (Nather page 76). If health insurance companies raise rates too much, they will be removed from the exchange.

Since the implementation of the Affordable Care Act, some may argue that access to quality health care and services are easier to obtain. The law mandates that all citizens of the United States as well as those individuals who are non-citizens, but are legal residents, acquire health insurance coverage. In order for there to be minimal barriers to accessibility of health coverage, an online health insurance marketplace provides individuals with the option to shop for health insurance plans. The plans are categorized by the state in which the individual resides. The exchange allows individuals to review plan specifications. Additionally, the exchange provides coverage options through participating insurers through a tier system. The consumer is able to make a comparison of services covered in each tier, prescription costs, as well as premium costs associated with each health plan. From that, consumers have information about an array of detailed plan options and covered services in which to make an informed decision and purchase coverage that best suits their individual needs as well as the needs of their family.

Within the PPACA legislation, there are provisions that create health insurance exchanges to be accessed by uninsured individuals. PPACA envisioned this access to health exchanges providing early detection and treatment, thus bending the healthcare cost curve (Dixon, 2014). Since national health reform had failed in the past, PPACA intentionally chose a national health care model that included health care exchanges that would be primarily managed by the states (Sirpal, 2014). After the forceful United States Supreme Court decision in 2010, states were given a choice whether to establish health care exchanges (Sirpal, 2014). Since 2014, the White House (2015) believes that a total of approximately nineteen million people have enrolled in the

Howard, E. (2010). Health insurance exchanges: house or senate style. The Commonwealth Fund. Retrieved from

With the Health Insurance Marketplace opening October 1st, insurance companies will compete as providers for individuals’ business via the Affordable Health Insurance Exchange, an online marketplace. Many health care provisions are

New Health Insurance Marketplaces: It allows individuals to compare Health insurance plans that count as minimum essential coverage and include all new benefits, rights and protections.

Under the Affordable Healthcare Act implemented in 2014, an insurance plan that is certified by the Health Insurance Marketplace, provides essential health benefits, follows established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts), and meets other requirements. A qualified health plan will have a certification by each Marketplace in which it is sold. (Healthcare.gov)

Insurance purchased through federal marketplace exchanges contain high deductibles and high co-pays, causing high out-of-pocket costs. The introduction of insurance exchanges, coupled with the financial penalties of the individual mandate, added approximately 11 million individuals and families to the healthcare market-place (Sun, 2016). The exchanges allow individuals to shop for insurance plans that contain varying levels of coverage. Although these plans cover preventive services, they do not protect against out-of-pocket costs. Research suggests that copay amounts under exchange plans are 20% higher than those of employer-sponsored plans. Furthermore, studies show that deductible amounts for some exchange plans are five times greater than for employer-sponsored plans

The Health Insurance Exchange is a marketplace for consumers to purchase health coverage that is affordable. This marketplace gives consumers the option to compare various health insurance companies to find the best option for them. The marketplace is regulated under Federal standards. Prior to the full implementation of the ACA, in 2013 the United States spent about $90,085 per person on healthcare. This was more than eighteen percent of the GDP, gross domestic product in the United States. (Mangan, Dan) Another goal of the Affordable Care Act and the Insurance Exchange was to provide health coverage to the forty three million Americans that were uninsured in 2013.

HealthCare.gov is a restorative scope exchange site worked under the United States focal government under the game plans of the Patient Protection and Affordable Care Act (ACA, much of the time known as 'Obamacare'), planned to serve the occupants of the thirty-six U.S. states that picked not to make their own particular state exchanges.[1][better source needed] The exchange supports the offer of private medicinal scope game plans to inhabitants of the United States[2] and offers assignments to the people who win under four times the administration destitution line. The site moreover helps those individuals who are fit the bill to consent to Medicaid, and has an alternate business community for private

A health insurance exchange is the online marketplace individuals use to purchase health insurance. The official term used when referring to the exchange in “health insurance marketplace.” It is estimated that the online exchanges will provide almost 29 million American citizens with reasonably priced health insurance.