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The Common Man's Exchange

Very mention of the word 'Exchange' in the United States is associated with Health reform and the PPACA act, and why not? This is probably one of the most discussed topics today! The Exchange which is supposed to make insurance purchase simple for the majority of uninsured & underinsured population has courted a lot of controversy and issues around implementation costs, self-sufficiency & sustainability, political conflicts, regulatory uncertainty etc.


While the act mandates that every individual needs to be insured by Jan 2014, the current scenario has confused the consumers as they grapple with basic questions - 'Should I purchase insurance right away from an existing agency or a private exchange? Or 'should I wait for the reform which claims to provide subsidies?' Something else that is troubling consumers is the confusion around release of such exchanges - every other State has its own conflicts with the federal government and is un-decided whether to set up an Exchange or not. Consumers are trying to understand -


  • What will happen to these Exchanges if and when there is a change in the government?
  • What will happen if a plan is discontinued in an Exchange due to non-conformance to federal standards and will the Exchange be able to provide an equivalent plan as replacement?
  • If and at all I have certain benefits from an insurance company due to loyalty to a certain plan even though I might be underinsured, is the switch to a new Exchange worth it?
  • Would I rather pay the fine than pay the big premium for my entire family?

As a consumer, what would interest me, should be the priority of every Exchange and every platform associated with it. The stakeholders responsible for designing these platforms should be able to resolve such issues quickly and make the process easy and seamless.


Every Exchange should be able to:

  • Tell consumers why they need insurance and what would be the benefits of buying insurance early
  • Explain why paying is not a preferred solution
  • Contract with payer partners to continue the "no-claims bonus" or other loyalty benefits
  • Simplify navigation and be User friendly - should make the process of insurance purchase as stress free and non-chaotic as possible
  • State facts clearly - be accountable & transparent

Most of the private exchanges look jazzy, carry a lot of fine-print and give an impression of being expensive. A successful exchange should address these and enable consumer to -

  • Choose suitable cover which does not have any hidden clauses and conditions
  • Choose a payer who would not hike rates unreasonably once the plan is purchased
  • Choose plans according to the quality of care the payer promises to provide 

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