Delaware Attempts to Try a New Approach with Its State Health Insurance Exchange

Delaware is one among the few US states that embraced the Affordable Care Act and began with its state health insurance exchange implementation early. The Delaware State has suggested some guidelines that it feels can be helpful for running other state health insurance exchanges across the US.
Delaware is taking strong strides towards meeting the January 2014 deadline for setting fully functional health insurance exchanges and is drawing plans on how the state health insurance exchange would actually operate.
As per the January statistics published in a report by the White House, Delaware has already received $4,400,096, - $1,000,000 exchange implementation grant and $3,400,096 Level 1 establishment grant - in federal grant to set up its state health insurance exchange. Establishing and running an exchange is costly business and small US states are understandably concerned about the high insurance exchange maintenance and management costs.
Delaware proposes that either the government agency, Delaware's Department of Health and Human Services or some other not profit group can manage the insurance exchange. Private insurers and carriers currently operating within the state can offer plans through their private insurance exchanges, considering that they meet certain predefined plans' criteria.
Some of these mandatory benchmarks for health plans participating in health insurance exchanges are as follows: 1) The plans should not surpass premium limits which are calculated based on income. 2) Plans cannot charge premiums greater than 9.5% of family earnings that fall between 300-400% of the federal poverty level. 3) All the health plans should mandatorily provide 60% cover benefits.
Delaware has projected that 35,000 individuals would be enrolled in health exchanges by the year 2015.
The government however believes that it is best if the states run their own exchanges as states are likely to have a better understanding of their local markets and consumer needs and preferences. Delaware itself wants to be involved in the monitoring and regulation of the participating health insurance plans, consumer outreach initiatives and other endeavors dedicated towards educating more residents about their insurance options.
As per an analysis conducted by a Delaware firm, one of most cost-effective model for state health insurance exchange may be that the state controls and monitors the plans and customer outreach programs and the federal government takes care of the health insurance exchange infrastructure, technology setup, database management etc.
Delaware hopes that the setting up of state health insurance exchange would also kick-start the insurance market competition within the state, in terms of better health plans available at competitive rates. State health insurance exchange participating insurers would have access to a currently untapped fresh consumer market which can result in explosive rate of enrollments for health plans.
State health insurance exchange can not only completely restructure the way health insurance is offered and purchased in the state but can also help in better management of residents' health and in uplifting the state health insurance market to newer, previously un-scaled heights.
Author is a well known authority on health insurance Exchange in the US. He is currently looking to expand his expertise in health care software and healthcare software solutions available.

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