Inside Health Insurance Exchanges Features Joel Ario
“Four Months After Leaving HHS, Ario Remains Bullish on Exchanges”Inside Health Insurance Exchanges
February 1, 2012 – Inside Health Insurance Exchanges published an article featuring Manatt’s Joel S. Ario, a managing director with Manatt Health Solutions, the firm’s interdisciplinary policy and business advisory division. In a Q&A session, Ario offers his perspective on the hurdles and opportunities health insurance exchanges will create for health plans and states, as well as his thoughts on how a system of state-based exchanges will alter the health insurance landscape.
When asked what he sees as the biggest barriers health insurers will face in developing and selling qualified health plans through state exchanges, Ario said:
The transition to guaranteed issue in the individual market will be challenging. It is the heart of the law and is the key to covering everyone, but it will require insurers to change their business models. In essence, they will have to compete for individual business the way they compete for [administrative-services-only] business in the large group market.
With large employers, insurers do not identify the most costly people and put them in a separate risk pool. They work with employers to manage costs of the overall pool … healthy and sick. Risk selection is deep in the DNA of insurers, and they are very worried about the 2014 transition. But Massachusetts shows it can work if everyone cooperates.
The bottom line is that the alternative to implementing this law is a whole lot more uncertain and there are potential downsides for insurers.
Ario also discussed whether he thinks HHS will have a federal exchange platform ready in time for enrollment on October 1, 2013, and he answered other questions concerning politics and exchanges.
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