Bruce Shutan

After two years of health plan enrollments in the emerging online marketplace, it’s possible that public and private exchanges are finally converging.

Health care consumers in some parts of the U.S. may face higher premiums next year if some insurers struggle to cover their costs and Congress continues to require that the risk-corridors program established under the ACA be self-sustaining.

Covered California’s Small Employer Health Options Program (SHOP) is growing, but a private-sector competitor to the state-run HIX is growing even faster.

What happens if the U.S. Supreme Court decides next month to eliminate federal subsidies for as many as 10 million consumers in 37 states and carriers are unable to cover claims based on rates they've already submitted to Healthcare.gov?

Highlights of the expected legislation include limiting tax exclusions on employer-provided health insurance to $12,000 for individual coverage and $30,000 for family coverage and dismantling Medicaid expansion under the Affordable Care Act in favor of state grants.

A new $250,000 national advertising campaign running on several popular political TV programs casts the Affordable Care Act as a positive force that is saving lives. It also seeks to counteract continued threats of repeal or scaling back the landmark legislation.

About 25% of health plans in two state-run public exchanges were found to violate the federal mental health parity law, according to research by the Johns Hopkins Bloomberg School of Public Health that was published in the journal Psychiatric Services.

Best-performing state exchanges have thrived on strong, coordinated and targeted outreach, as well as enrollment-assistance programs that are embedded in the community.

Remote access to care is expected to soar as telehealth offerings prove to be major time and money saver for employers.

Some New Yorkers can choose from more than a hundred health insurance products offered by more than a dozen insurers participating in the state-run health insurance exchange, depending on where they live, but they’re hard-pressed to find anything other than the HMO-style plans that dominate the landscape.

In the Land of 10,000 Lakes, concern has been mounting that Minnesota’s state-run HIX is slowly sinking into insolvency exacerbated by downward revisions in projected enrollment and speculation that it could be supplanted by Healthcare.gov at some point.

More than 1 million Americans enrolled in consumer operated and oriented plans known as CO-OPs over the past 18 months during which average premium rates in states with these nonprofit alternatives to commercial carrier options were found to be lower than those without such plans.

There may be a convergence of public and private exchanges and if that happens carriers need to adopt a more holistic approach and consider multiple retail channels to distribute their products as part of a multi-carrier approach or alliances such as those seen within the CO-OP market.

Technical difficulties may have marred public exchanges' first year of operation, but at least providers were able to breathe a collective sigh of relief about not being inundated with a sharp increase in new or sick patients scheduling appointments.

While several reasons have been suggested for a plateau effect in public exchange enrollment, it may all come down to dollars and cents, as well as carrots and sticks.

While the U.S. Supreme Court ponders its decision in King v. Burwell, a senior economist at the nonprofit, nonpartisan RAND Corporation suggests that the time may have come to re-evaluate the tax-favored status of employer-provided health benefits coverage to offset the costs of lost subsidies, maintain budget neutrality and end a bifurcated system that favors the wealthy.

Sometimes what happens in Vegas doesn’t just stay on the Strip – it blows across the Sagebrush State like a wayward tumbleweed. Case in point: Nevada Health Link enrollees have been reporting mistakes on the 1095-A IRS forms to calculate their premium tax credit on the federally supported state-based HIX.

If there was a most-improved public HIX award, Maryland Health Connection certainly would be in the running for such an honor. Nearly twice as many state residents enrolled for 2015 in half as much time compared to the previous year.

While the Affordable Care Act bans pre-existing condition exclusions, cherry picking and higher premiums for sicker individuals, a 2014 federal discrimination complaint and new study suggest that some public exchange plans have jacked up certain prescription drug prices.

As many as 90,000 Sears employees are finding it easier to shop for health care, are savvier about their coverage choices and finally understand the meaning of value since the 129-year-old retailer switched to a private health insurance exchange three years ago.