State insurance exchanges — mandated to start operating in 2014 to offer one-stop health insurance shopping for individuals and small businesses — could sell up to $60 billion in policies during their first year and nearly $200 billion by 2019, according to estimates from consultancy/research firm PricewaterhouseCoopers.

And the exchanges will work as intended, as 97% of those covered in the first year will previously have been uninsured, the company asserts. For now, however, consumer education is necessary — more than 80% of consumers eligible for subsidized coverage through the exchanges don't yet know it.

The PwC report, "Change the Channel: Health Insurance Exchanges Expand Choice and Competition," is based on a national survey of 1,000 consumers and 153 health insurance executives, as well as in-depth interviews with 35 executives representing state insurance exchanges, insurers, policy makers, consumer advocate organizations and quality organizations. Findings include:

  •  Fifty-two percent of surveyed insurance executives expect their companies to participate in the exchange, 17% do not intend to participate and the balance of insurers are considering participating.
  •  Insurers' biggest worry about the exchanges is receiving a disproportionate number of high-risk patients, while their second biggest worry is integrating company technology with the exchanges.
  •  Three-quarters of consumers want more information about what is and is not offered in a benefit plan. Many also want tools that enable easy comparison of plans or estimate prices for common procedures.
  •  Sixty-one percent of consumers want insurers to offer discounts or gift cards for healthy behavior, while consumers aged 18 to 34 are three times more likely than those over 45 to give up their choice of a physician for a lower cost policy.

The report is available at Registration is required.

— Joseph Goedert writes for Health Data Management, a SourceMedia publication.

Register or login for access to this item and much more

All Employee Benefit News becomes archived within a week of it being published

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access