The New Health Exchange
Lee Green, the Vice President of Sales and Marketing, Scott and White Health Plan was introduced by Rotarian of the Day, Scott Clark last Thursday.
Mr. Green addressed the changes to health care due to the Affordable Care Act. He will also be presenting at the Chamber Legislative Luncheon on January 8. The Patient Protection and Affordable Care Act was passed on March 23, 2010.
Approximately 50 million people out of 330 million do not have health care. On October 1, 2013, enrollment in the health care program went live with a myriad of problems. The Affordable Care Act anticipated that 7 million individuals would sign up with about 1 million to date signing up. Interested individuals can go to the website atwww.healthcare.gov or people can shop at the Health Insurance Exchange (HIX). The HIX allows someone to shop for insurance options based upon income, age, and zip code. On the Affordable Care Act, you will generally find health insurance plans for individuals meeting low income requirements. Included in the act is a requirement that everyone has a qualified health plan or have a penalty by January 1, 2014. Many are not signing up because the penalty is less than the cost of the health insurance plans. Additionally, insurance companies are required to accept whoever applies.
In Central Texas, 319,000 citizens remain uninsured. These individuals go to the emergency room or urgent care clinics.
The implications of the changes in health care include greater access for more people, the ability to shop for insurance options, greater expenses for health care providers for procedures including maternity and mental health, narrow networks for subscribers, more out-patient settings, a great emphasis on well care, and supplemental health insurance plans. Mr. Green summarized by saying, “some people are going to win and some are going to lose.”