The ACA tells states that they must set up an insurance marketplace (called exchanges) in which individuals who are otherwise insured and small businesses may shop for policies. States have broad discretion in setting up these exchanges, including the makeup of a board to guide the development of the exchange and its policies.
The Raleigh, (N.C.) News and Observer this morning has a story about an emerging dispute about who will have seats on the board that governs the creation of exchanges in N.C. At issue is who will be represented on the board. A current bill under consideration in the N.C. General Assembly would grant a seat to Blue Cross/Blue Shield of N.C., the dominant insurer in that state; seats for two other insurers; representatives from the business community; the State Medical Society; and the hospital Association. What is missing are consumer advocates, say critics.
I agree a consumer voice on such a board is important, but think that some other types of voices are also needed, notably:
- health policy type(s) from the large research community, both university based and otherwise that exist in our state;
- experts in communication of complex information. More than marketing is needed, but insight into how information on plan design is communicated to help people make their choice of plan. I am a health policy guy and my wife is a nurse, and we still often puzzle over the materials that Duke provides to help us decide what plan to pick. Communication of plan design, premiums and deductibles in a way that stands up to people then living their lives is crucial for success of any private-insurance based reform.