Right now the state has taken the federal grant to explore setting up a state base exchange vs a federal exchange.
This is very important on the future of health insurance and health care in the state of Indianapolis.
If it is a state based exchange then we should see competition within the carriers operating inside of the exchange maybe. We would also see the agents role with assisting people on obtaining the best plan. We are fortunate to have a department of Insurance that works towards finding the best possible option for an exchange. Currently two models are being analyzed. That would be Utah and Massachusetts exchanges. Utah has developed their exchange with lean towards employer based plans. This is where small groups can participate in the exchange. They have had major problems with keeping the exchanges competitive. They also have run into problems with employers being able to admin a small group plan. The Massachusetts exchange is more of a universal health plan with state mandated coverage. Premiums are very high where a Family of 4 costing $17,000 a year. The Mass. exchange has major problems because the carriers are losing money and can not stay solvent long term.
If the DOI decides that a state based exchange has really no chance to help Indy residents they will shift it to a Federal Exchange. A federal exchange might have little success in helping Indianapolis residents. Right now the federal government might not see the role of the agent/broker as important. They might establish federal employees that are called health navigator to help people on health insurance. The navigators would not be licensed or be held accoutable for advise that they give. It is also thought that a federal employee will not work as hard a broker/agent that is paid on commission. The federal exchange might have problem with recruiting carries to participate in it. In fact we might see carriers that decide to compete against the exchange.
One of the big issues of the health care reform law that must be clarified. Is the tax credit or subsidy for the exchange. If there is a tax credit that mean people will still have to pay the full premium and wait to get the tax credit back. $17,000 could be difficult for most families to pay and then wait for the credit. If its a subsidy then the federal gov. could pay a portion of the premium towards the carriers which would no doubt lead to a higher premiums.
Its going to be very interesting to see what happens on the exchange.