Health policy watchers could get ideas about how the new health insurance exchanges will work, or not work, by thinking about how exchange users might compare with the users of the Pre-Existing Condition Insurance Plan (PCIP) program.
Jean Hall, a health policy researcher at the University of Kansas, makes that case in a commentary published by the Commonwealth Fund.
If the exchanges start up on schedule and work as expected, users will be able to buy the coverage on a guaranteed-issue basis. Health insurers will have only a limited ability to use age and other personal health information to set rates. The exchanges will help low-income users sign up for Medicaid and other government health programs, and they will help moderate-income users use new tax subsidies to buy private health coverage.
The drafters of PPACA included the PCIP provision in an effort to provide immediate relief for uninsured people with health problems.