PwC: Detailed Profile on Health Insurance Exchange Population
October 7, 2012By Rob Starr, Content Manager, Big4.com
A new report from PwC?s Health Research Institute (HRI) projects that more states are likely to involve the federal government than previously expected.? The report, Health Insurance Exchanges:? Long on Options; Short on Time, released today, also provides one of the first detailed profiles of the population expected to enroll in the newly created exchanges.
The 12 million Americans expected to begin enrollment in the exchanges next year represent a new, emerging healthcare customer base with a demographic profile and health needs that differ from the current insured population, according to HRI analysis.? States have two crucial decisions to make this fall that could have a big impact on this group?s patient care a decade from now: whether to expand Medicaid coverage and how to create an open insurance marketplace that meets their needs.
State-based exchanges will create an irreversible shift in the insurance market that ultimately changes the way medical care is sold in the U.S.? For the insurance industry, they represent a major business opportunity ?a market that will translate to$205 billion in premiums by 2021.? The size of the exchange market will vary depending on states? decisions to expand Medicaid eligibility to 138 percent of the federal poverty level, an option granted by the Supreme Court ruling in June.
The concept of an insurance marketplace is not entirely new.? Private purchasing exchanges exist today and are run by insurers or third parties and offer a variety of options to employers and individual consumers.? These private exchanges are in many ways the precursor to public exchanges, and in the future may create an alternative both for employers and for individuals who do not qualify for government-subsidized insurance.
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