Q&A with Loyola Sellinger School’s Gloria Phillips-Wren About Health Insurance Exchanges

Gloria Phillips-Wren

1. What are state health insurance exchanges?
State health insurance exchanges are competitive marketplaces for consumers to shop for a health insurance plan much as we shop for a car, with different models, prices and options. The plans vary from state to state and are offered by private companies.

2. How is Maryland’s health insurance exchange different than other states?
Each state has its own health insurance exchange, and each state decided whether to run the exchange themselves or let the federal government do it. Maryland is running its own exchange with plans available just to Maryland residents.

3. When will we know the Affordable Care Act’s effect on health care utilization, delivery and cost?
I think it will be five-to-10 years, in my opinion, before we begin to know the effect of the ACA on health care utilization, delivery and cost. At the moment we have 50 experiments going on in our 50 states, each with different plans and populations. The best ideas from each of these will hopefully come forward to improve the overall health care situation in the United States.

4. What kind of Affordable Care Act-related research is Loyola’s Sellinger School doing? What are the goals of the research?
Some faculty at Loyola have been researching health care issues for over two decades. Some of the studies look at health care utilization, some at cost impacts, and others at health care outcomes and delivery of care. One of our current projects related to the ACA is to characterize different states now before the law goes into effect, and then compare the utilization of health care services in different states as the law rolls out. Hopefully we will be able to identify some best practices based on the data. I expect that policies in the ACA will evolve as we learn more about the exchanges and people’s reactions to various provisions of the law.

5. How will the health insurance exchanges affect large and small businesses?
Businesses will be weighing their options as plans on the exchanges become clearer, so we won’t know the effect right away. Although no employer has to offer health insurance coverage, the law establishes standards that large and small businesses must meet to help employees obtain health insurance.

6. How should business owners prepare for the transition?
The best advice to business owners is to learn your options! Parts of the law pertaining to business have been delayed for one year to give time for businesses to understand and implement them, so this is the time to understand your choices and responsibilities under the law.

7. Do you have any predictions about the exchanges moving forward?
I think that we all recognize that health insurance is essential and yet unaffordable for many people. The exchanges, along with other provisions of the ACA, offer an opportunity to allow competition and incentives (and disincentives) influence the cost and quality of health care in the United States.  Initially I think it will be a little confusing with all the options, yet I think that the American public will like the exchanges once they are operating smoothly.

8. How will the exchanges’ technical glitches affect outcomes?
I don’t think that there will be a significant impact from the technical glitches we’ve seen so far. All of us are used to working around technology issues as they occur, whether it be our cable service or that new cell phone that we waited in line to get. The great thing about the Internet delivery of the exchanges is that we can try again later if it doesn’t work the first time.

Dr. Gloria Phillips-Wren is a professor and chair of information systems and operations management at Loyola University Maryland’s Sellinger School of Business and Management (www.loyola.edu/sellinger).

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