Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

More Time Needed to Launch State Exchanges, Highmark CEO Says

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

More Time Needed to Launch State Exchanges, Highmark CEO Says

Article excerpt

Despite the federal government's drive toward its 2014 health care overhaul goals, the chief executive of Pennsylvania's largest plan isn't sure there's enough time left on the clock.

There's "a lot of concern about the ability [of the government] to go live," Highmark CEO William Winkenwerder Jr. said.

After meeting with national health industry leaders in Washington, D.C., last week, he said he came away with the sense that the state-based health care exchanges -- the online clearinghouses where people can shop for health policies -- may not be ready to go by October 2013, when the enrollment period is scheduled to begin.

Beyond the actual construction of the online exchanges, the federal government also has to figure out how the subsidies will be disbursed to those who can't afford full-priced policies and how it will work with the states that want partial, but not full, control over those exchanges.

"It's a lot of complex work, with the IRS, with each of the states," particularly the states that are still uncertain about whether they want to expand their Medicaid programs, Dr. Winkenwerder said.

He met with reporters Thursday morning to discuss the state of the health care industry and implications of the federal health care overhaul. Questions about the company's rivalry with UPMC and its on- again, off-again rescue of the financially struggling West Penn Allegheny Health System were off the table.

One byproduct of health care changes, he said, will be a steep increase in the premium costs for individual policies for those under 40, particularly young and healthy men. Because of a new regulation that essentially caps the cost of the most expensive policies within a certain product class, young men, who are used to lower premiums, will end up being charged more.

Some premiums for the so-called "young-and-healthies" could go up by as much as 200 percent, he said.

"That alone is going to be a shocker for a lot of people," he said. "Their rates are going to go up pretty dramatically," and could have the effect of driving those people out of the insurance market, opting instead to pay the annual penalty for not obtaining health insurance. …

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