Health: Insurance marketplace

In most universal healthcare proposals now before Congress, Americans would shop for coverage at an "insurance marketplace," sometimes called an "insurance exchange."



What's that? It's a Web site that gives consumers one-stop shopping and helps them compare insurance plans.

Federal employees are accustomed to it. When they are first hired, they go to a Web site that helps them compare prices and benefits of various medical plan choices. Each year, they can switch to a different plan if they like.

Want to see such a marketplace? Type "federal employees health benefits program" into a search engine. The list of plans under health reform would be different, but the marketplace would basically work the same way.

If a health insurance company, private or public, wanted to offer a plan on the marketplace, it would submit details for review. It would have to prove it had enough reserves to cover claims, and prove it met standards of the reform system.

So consumers would know that any plan listed on the exchange had been certified to meet standards spelled out by law. If the new federal law said companies could not drop customers who develop an illness, for instance, no plan on the list could drop a customer who became sick.

Most choices would probably bear familiar names: Blue Cross, State Farm and so forth. If a government-run "public plan" or non-profit health collective is authorized, they would be on the list too.

Hundreds of millions of Americans would choose insurance from this marketplace. Theoretically, the sheer numbers would put insurance companies under enormous competitive pressure to keep prices low.

Would insurance plans be allowed to deny coverage for pre-existing conditions? Would they be allowed to drop coverage after customers got sick? No - not under the mandate President Obama issued to Congress.

If a public plan is on the list, its rates would be low. Private insurance companies are spending billions in a lobbying blitz to block a low-cost government-run alternative. No wonder. They're spreading scary misinformation that is repeated by "tea party" protesters who rant angrily, without understanding what they're angry about.

The price of U.S. health insurance has doubled in the past 10 years. At the current rate, an average American family policy would cost $36,000 within eight years, according to the Milliman Medical Index.

A regulated health insurance exchange that includes a public plan would go a long way toward preventing that horror. Showing political courage and insight, Sen. Jay Rockefeller is insisting that a public plan be on the exchange list. Will the rest of West Virginia's delegation in Congress do the same?