What is the Mi Health Marketplace?
Under the Affordable Care Act, Michigan has the ability to create a health insurance marketplace - also referred to as an Exchange - that will allow individuals and small business to join together to negotiate for insurance premiums and discounts the way larger companies do. The marketplace should include an easy-to-use website that lets consumers make real comparisons between health care plans. Well-trained, independent guides should also be available to help consumers decide which coverage option is best for them within the Exchange.
Who Will Use Michigan's Marketplace?
Participating in the Health Marketplace is voluntary – everyone who already has an insurance plan they like can keep it. For those who need coverage, the Marketplace will offer better access, more choice and fair prices by allowing individuals and small businesses to join together to obtain competitive premiums and discounts.
Starting in 2014, members of Congress will be getting their health insurance through these state Marketplaces, too.
Who Should Run the MI Health Marketplace?
Decisions made by the Marketplace should benefit the people of Michigan, not insurance company bottom lines. In order to do this, the Marketplace should have a governing board that includes consumers, small businesses and insurance experts who don’t work for the industry. This will ensure that the board makes smart decisions that reflect the interests of those who will be utilizing the exchange and improves both quality and efficiency of the Marketplace while avoiding conflicts of interest.
Insurance industry representatives and brokers that stand to profit from enrollment in the Marketplace should not be a part of the board. Instead, the board should include experts who have strong technical background – like an insurance commissioner, a representative from the state employee benefits plan, an academic expert or economist – without the industry’s conflicts of interest.
What Should the vMarketplace Look Like?
The health Marketplace should have a user-friendly website – similar to Travelocity or Consumer Reports – that allows consumers to search for the plan that’s right for them. The website should make it easy for consumers and small businesses to compare health care plans and make an informed choice by showing apples-to-apples comparisons across all plans. The site must be closely monitored to prevent fraud and protect consumers.
How Will Consumers Find the Right Plans?
The Health Marketplace should help eliminate bureaucracy and confusion as consumers look for the right plan for their budget and health care needs. The Health Marketplace board will appoint guides - called Navigators – who will help consumers decide which coverage is best for them. Navigators should be independent and unbiased to ensure their assistance focuses on what’s best for consumers, not their own bottom line. Navigators could be community nonprofits, unions, chambers of commerce, or other organizations that are trusted in the community and equipped to help the consumers in Michigan find the right plans.
As an additional step to eliminate unneeded bureaucracy, a Health Marketplace should work seamlessly with Medicaid to ensure that consumers receive coverage under the right program.
What Types of Plans Can a Health Marketplace Offer?
Michigan’s Health Marketplace should have the power to negotiate with insurance companies to ensure consumers receive high-quality health plan options at affordable prices. The Health Marketplace should have the ability to determine which health plans should be accepted into the Health Marketplace and which don’t meet the standards necessary. So there is a variety of options and pricing competition, Michigan’s Health Marketplace board should require insurers of a certain size to submit plans for approval in the Health Marketplace.
Michigan’s Health Marketplace board should also work to provide consumers with the best options available by rewarding plans with payment incentives for providing strong benefits (such as coordinated, high quality care), reductions of hospital readmissions and reductions in health care disparities.
How Can the Health Marketplace Help Ensure High Quality and Affordable Prices?
Michigan should maximize buying power by creating a single state Health Marketplace that allows negotiation of good prices, rather than multiple regional Health Marketplaces within Michgian. The Health Marketplace can also keep costs down for all consumers if it prevents insurers from selling lower-quality plans outside the Health Marketplace. Strong private insurance rules that maintain fairness, limits on premiums and guaranteed renewability should also be mandatory for both Michigan’sHealth Marketplace and insurance plans outside of the Health Marketplace.
How Does a Health Marketplace Benefit Consumers?
Rather than letting insurance companies dictate the price of coverage, the Health Marketplace can give consumers the power to negotiate with insurance companies – driving down costs and improving the quality of health care options. By establishing a strong Health Marketplace, more Michiganders currently without insurance will be covered and receive the health care they need.