Competition makes health insurance better

Posted: August 16, 2011

ANYBODY who's booked a flight on Travelocity knows the value of comparative shopping.

Delta may have the best price, but Continental can get you there without a connection. The airlines compete, and you decide. Sites like Travelocity have made air travel, car rentals and hotel bookings more convenient, competitive and affordable.

The same can't be said for health insurance, but that's about to change. The federal Affordable Care Act calls for the creation of competitive health-insurance marketplaces by 2014 to provide individuals and small businesses with a place to buy high-quality, affordable health coverage.

Each marketplace will feature an easy-to-use website, letting consumers compare plans to find one that meets their needs and budget. The marketplace will also connect consumers with federal assistance to purchase coverage. The marketplace is voluntary for people who lack health insurance, have lost their coverage or are unhappy with the policy they have. If you have insurance and are satisfied with it, you can keep it. States must establish their own marketplaces or let the federal government create one for them.

For those who need health insurance, the marketplace will offer better access, more choices and fair prices. Middle-class Americans and small-business owners will be able to leverage their collective-buying power and drive down costs.

But state officials should take steps to create a competitive marketplace that serves the people of Pennsylvania, not an insurance company's bottom line.

Plans offered in the marketplace should be held to quality standards so that consumers know they're getting a good product. Rules should prevent insurers from raising premiums unreasonably and ensure that co-payments, deductibles and other cost-sharing are reasonably limited based on family income.

If insurers wish to raise their rates, they should be required to disclose this to the public and be held accountable for the premiums they charge consumers.

The marketplace's board should include patient voices, small businesses and insurance experts who don't work for the industry. They should have the authority to negotiate with insurers who want to sell their products on the exchange in order to secure the best prices and protect consumers against abuses like denial of care.

Finally, the marketplace should be accountable, transparent and easy to use. Policies should be explained in clear language, and well-trained navigators should be available to help individuals and families decide which coverage is best for them.

A strong marketplace will open the door to high-quality, affordable health coverage for more than a million uninsured Pennsylvanians, including more than 300,000 individuals in this region. Insuring a larger share of Pennsylvanians will create jobs and improve the health of our workforce.

A competitive marketplace will give consumers more control, better choices and greater protections when buying insurance. That's good for consumers, businesses and Pennsylvania.


Antoinette Kraus is project manager for the Pennsylvania Health Access Network.

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