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Keeping You Covered

Posted by admin on January 22, 2014

Making Health Care Reform Work for Hoosiers
By: Robert Hillman, president of Anthem Blue Cross and Blue Shield in Indiana

The recent launch of the Health Care Marketplace, or exchange, presents an extraordinary opportunity for the uninsured and a transformational time for the health insurance industry. Anthem Blue Cross and Blue Shield supports the goal of expanding health insurance coverage in Indiana.

To be sure, changes to a system that represents 1/6 of our economy are inherently complex and there will be challenges during implementation. But as the state’s largest health benefits company, we are trying to make it as easy to understand as possible.

The Affordable Care Act provides expanded benefits to include doctors’ visits and outpatient services, emergency care, maternity and newborn care, and prescription drugs. Additional covered items are preventive exams, screenings and immunizations. Insured individuals receive these benefits without incurring any out of pocket expense. Plans with lower deductibles are also required in some instances and government tax credits are offered as well for individuals and businesses who qualify.

For the past three years, we’ve been doing our homework. In preparation for this new “retail”, consumer focused selling environment in the health care industry, Anthem created the largest database of consumer preferences of any health insurer, running more than 55,000 consumers through an exchange simulation where we not only asked them a series of questions to get to know them as people but also to know what they are looking for in terms of tradeoffs—things like levels of coverage, premiums, networks. The result of the simulations proved the most important aspect for a consumer in selecting coverage was—price.

Many insurers have chosen to sit out the Health Care Marketplace. However, given our position as a market leader in Indiana, we believe Anthem has an obligation to make health care reform work for Hoosiers. That’s why we’re offering competitive products on both the Individual and Small Group (SHOP) exchanges in all parts of Indiana.

If you’ve ever booked a vacation through Travelocity, you’ve used an “exchange” to compare and purchase a service. Similarly, the health insurance exchange’s purpose is to allow individuals and businesses to shop and compare various plans by price, benefits, copays, deductibles, and prescription coverage and provider networks.

It should be noted that because the law guarantees health coverage for all who apply, adds essential health benefits, eliminates restrictions on preexisting conditions, requires community rating and includes new federal taxes and fees that get passed on, some may find their costs will go up. Others will see their costs go down.

Because of the unprecedented nature of the changes that are being unveiled, there have been some challenges. That hasn’t been unexpected. But ultimately it will be worth the time it takes to weigh all your options and decide on a plan that works for your business and your employees.