Health insurance exchanges examined as part of reform proposals

Health insurance exchanges are part of every health care overhaul proposal now in Congress as Utah becomes just the second state to try its own exchange on for size.

The New York Times: "In theory at least, the exchange would fix a fundamental flaw in the present system by giving small businesses and individuals a broad choice of insurance policies at competitive prices. Right now, such buyers typically have few affordable options." But there remains little detail on them, The Times reports, and without fair play mandated by law in them, there may be little new competition — the most basic goal of the exchanges — to create savings in the system (Abelson, 10/5).

In a second story, The New York Times looks at Utah's try at an exchange, just like Massachusetts did, but with some significant differences. "Aimed initially at small businesses, the exchange offers a way for companies to pay a fixed amount toward their employees' medical coverage, instead of buying the coverage directly for them. The workers then can select from various plans on the exchange. If they cost more than the employer's contribution, the employee pays the difference." The exchange has covered 2,300 employees from 230 small businesses and has five dozen policies from large insurers and regional ones (Abelson, 10/6).