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Deloitte Center for Health Solutions Executive Director Paul Keckley on the implementation of the health-care law and its impact on states.
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To bring in our next guest joining us now with more on health care exchanges.
And whether impact on -- wool affect providers meaning doctors individuals businesses is Paul -- -- Deloitte center for health solutions executive director.
-- you've heard what Peter said setting this up that not every state certainly by a long shot a signing up for the bad.
Let's stick to what what's the advantage of states having these insurance exchanges.
Probably.
Two advantages one would be the political advantage of saying instead of opting to have the federal government do it we did it ourselves and second.
The law laid out a framework but allowed states some flexibility.
And -- they determine what for instance essential health benefits would include in things like that so.
Probably the states they -- where they federally run exchange they have given up some of that flexibility now.
Most conservatives.
Associated with -- obamacare but some conservatives including former Mississippi governor.
Haley Barbour are in favor of these exchanges he of course was against -- -- but he was in favor of the exchange in Mississippi is rolling out what.
How does -- model.
Differ from others that conservatives don't like.
Well it it depends on you know the circumstance of a state were in a state you have a limited number of insurance choices already perhaps.
And exchange will.
Encourage new insurance companies to offer products through what's called a qualified health plan so.
Many of the southeastern states are dominated by water to ensure -- may be that makes that insurance market more competitive.
Okay while we like competition here fox business and certainly the free market but obviously if there's the -- the choice on the government side that'll be interesting to see how that plays out and that's what we wanna ask you.
Will we see any unintended consequences say for example with doctors and what about people who were covered right now by their employers will employers use this as an excuse to drop but if they're in a state that has one of the exchanges.
It's possible.
I think it's clear that employers have their eye on exchanges as a possible.
Exit strategy long term there are number of for pollution -- dropping coverage in the near term but you can envision our surveys say that employers have their -- on exchanges.
Thinking that at some point after 2016 perhaps.
Maybe it's better for them to pay the penalty lose the tax exemption and have their employees go to the exchange.
The second unintended consequence would be that.
What these exchanges are likely to pay doctors and hospitals for their services.
Is probably less than what employers in commercial health plans pay them today.
So it it could potentially increase.
The flight from practice that some doctors threatened it could it absolutely.
Threaten some of the margins of hospital.
As you know Paul one of the things one of the reasons why some conservatives like the exchanges because.
Our tax laws are set up in a -- that encourage businesses to buy insurance but not individuals to buy insurance.
And Haley Barbour and other conservatives who like the exchanges say look this way -- business can go to an individual employer or employee and say here's 101000 -- You -- -- -- exchanging get the best policy you watt you're the better judge of what's best for you.
So is that kind of use of the exchange.
Going to become something we're gonna see it all over the United States.
Well it's the discussion we're going to have David in this grand bargain and deficit reduction because the treasury would recognize about 200 plus.
Billion dollars.
If the employer tax exclusion went away and employers if you think about it they don't participate in your life insurance decisions your auto insurance.
But.
Through wage price control legislation eighty years ago they ended up.
Providing health benefits so it -- put to file -- a lot of what you're saying is there may be a way to equalize the tax treatment.
On health care programs to equalizer between employers and employees go ahead.
And that's that's that's a key discussion that's already on the table.
Why would an employer be able to expense this when individuals who abide on their own can't.
Paul correctly Deloitte -- for health solutions executive director.
He's a -- -- -- -- -- it goes -- right behind him there aren't sure -- -- -- field is the united his welder it's -- you'll thank you Paul good to see it thank you.
Well David many.
