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Jan. 9 Issue of AIS Newsletter Identifies Top Challenges for Exchanges in 2014
Date:1/15/2014

Washington, DC (PRWEB) January 15, 2014

A year ago, Atlantic Information Services, Inc.’s (AIS) Inside Health Insurance Exchanges (HEX) predicted that if everything went “according to plan,” 2013 would be the year that exchanges transition from policy to actuality, with fully functional state and federally facilitated exchanges (FFEs). But things didn’t go exactly as planned, and for its Jan. 9 issue HEX interviewed industry observers on the future of exchanges. These observers, including health care lawyers, consultants, former exchange officials and policy advisors, identify 12 challenges that public exchanges, insurers, agents and consumers will face in 2014.

The main challenge will be overcoming the “early chaos” of the newness of the marketplaces, recent policy changes and deadline extensions to pay premiums. Early implementation problems will include: people who thought they enrolled but never paid the premium and do not have coverage; people who enrolled and paid, but have no proof of coverage when they arrive at a hospital or doctor’s office; people who think they enrolled but their information was lost by the exchange; and people who enrolled, but didn’t understand elements of their coverage (such as the lack of out-of-network coverage, deductibles or coinsurances). Linda Tiano, a member of the health care and life sciences practice at the law firm Epstein Becker and Green, suggests this chaos will subside, however, after the next few months.

The second challenge will be insurer participation. Despite the lackluster enrollment in year one, carriers already participating on public exchanges are likely to continue for the 2015 plan year,
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