On January 17th, the Secretary of Health and Human Services proudly announced another $1.
5 Billion in state insurance exchange establishment grants to California, Delaware, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, and Vermont.
The Affordable Care Act is definitely designed to "pay if you play.
" These states are receiving the resources to research and develop their affordable insurance exchanges and create the vision of a market place where their residents will have access to quality, affordable health insurance.
Delaware, Iowa, Michigan, Minnesota, North Carolina, and Vermont received Level One Exchange Establishment Grants for one year to build their exchanges.
California, Kentucky, Massachusetts, New York, and Oregon received multi-year Level Two Exchange Establishment Grants to implement their exchange plans.
Think of Level One Grants as the research and development funding and the Level Two Grants as the implementation funding.
States are tasked with the development and implementation of the core requirements a state insurance exchange must meet.
Successful business owners succeed by investing their dollars in proven business models, products, and services.
Manufacturers do not build 1,000 new products unless they have a tested working unit they call sell for a profit.
Franchise organizations do not sell franchises until their business model has proven successful, and they have developed the infrastructure to support additional franchises.
Angel investors will not fund business ventures that do not have solid research and resources to allow their ventures to become successful.
There is simply a greater chance of failure if you don't go though the right process.
So why am I so concerned? Not one state has a functioning exchange model that has proven self sustaining.
Based on my 20 years of business experience many will simply fail or require additional funding which will eventually lead back to the taxpayer.
Not only are we wasting billions in taxpayer dollars creating a vision for the administration, but we don't even know if it will work.
Have we put the cart before the horse? Why don't we have a proven exchange model to understand the operating costs? Why don't we have all the insurance packages developed to understand premium costs? Why don't we have an IT infrastructure that states can simply choose to use instead of developing their own? Why don't we have research to understand the effects of multiple insurance carriers competing for business? These are just a few of the questions I ask myself over and over.
We are currently spending billions for states to research and implement their exchanges.
Why haven't we given them a functional model to start with? A well developed, proven, and customized exchange model could have been developed to allow states the freedom they need.
We have taken a different path.
Investing billions in a process that goes against everything business has taught us will result in failure and the American taxpayer will end up paying the price.
5 Billion in state insurance exchange establishment grants to California, Delaware, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, and Vermont.
The Affordable Care Act is definitely designed to "pay if you play.
" These states are receiving the resources to research and develop their affordable insurance exchanges and create the vision of a market place where their residents will have access to quality, affordable health insurance.
Delaware, Iowa, Michigan, Minnesota, North Carolina, and Vermont received Level One Exchange Establishment Grants for one year to build their exchanges.
California, Kentucky, Massachusetts, New York, and Oregon received multi-year Level Two Exchange Establishment Grants to implement their exchange plans.
Think of Level One Grants as the research and development funding and the Level Two Grants as the implementation funding.
States are tasked with the development and implementation of the core requirements a state insurance exchange must meet.
- Certifying, recertifying, and decertifying health plans offering coverage through the exchange by creating "Qualified Health Plans.
" - Assigning ratings to each plan offered through state insurance exchanges on the basis of quality and price.
- Providing consumer information on qualified health plans in a standardized format.
- Creating a calculator to give consumers the ability to assess the cost of coverage after application of any tax credits or cost sharing reductions.
- Operate an internet website and toll-free telephone hotline offering comparative information on qualified health plans and the ability to apply for and purchase coverage.
- Determining eligibility for the affordable exchange, tax credits and cost sharing reductions for private insurance, and other public health coverage programs, and assist with enrolling individuals in those programs.
- Determining exemption from requirements on individuals to carry health insurance, and granting approvals to individuals applying for hardship or other exemptions.
- Establishing a Navigator program to assist consumers in making choices about their healthcare options.
Successful business owners succeed by investing their dollars in proven business models, products, and services.
Manufacturers do not build 1,000 new products unless they have a tested working unit they call sell for a profit.
Franchise organizations do not sell franchises until their business model has proven successful, and they have developed the infrastructure to support additional franchises.
Angel investors will not fund business ventures that do not have solid research and resources to allow their ventures to become successful.
There is simply a greater chance of failure if you don't go though the right process.
So why am I so concerned? Not one state has a functioning exchange model that has proven self sustaining.
Based on my 20 years of business experience many will simply fail or require additional funding which will eventually lead back to the taxpayer.
Not only are we wasting billions in taxpayer dollars creating a vision for the administration, but we don't even know if it will work.
Have we put the cart before the horse? Why don't we have a proven exchange model to understand the operating costs? Why don't we have all the insurance packages developed to understand premium costs? Why don't we have an IT infrastructure that states can simply choose to use instead of developing their own? Why don't we have research to understand the effects of multiple insurance carriers competing for business? These are just a few of the questions I ask myself over and over.
We are currently spending billions for states to research and implement their exchanges.
Why haven't we given them a functional model to start with? A well developed, proven, and customized exchange model could have been developed to allow states the freedom they need.
We have taken a different path.
Investing billions in a process that goes against everything business has taught us will result in failure and the American taxpayer will end up paying the price.
Source...