Supreme Court Ruling on Healthcare Reform Offers Clarity to States and Insurers Alike

Yesterday the Supreme Court upheld the Patient Protection American Care Act (ACA), including the controversial individual mandate that requires all Americans to have health insurance. By upholding the law, nearly 30 million uninsured Americans will gain access to health insurance through state run insurance exchanges.  Under the law, by 2014 each state will be required to build and implement consumer-facing eCommerce platforms or Health Insurance Exchanges (HIX), for qualifying individuals to purchase their insurance. Put simply, the exchanges are an online marketplace for consumers to shop for individual insurance by comparing and purchasing plans from different health insurance carriers.

What this ruling means for States. Now that the ruling has been handed down, states need to act quickly to ensure they are compliant with the mandate to meet the 2013 and 2014 deadlines.  While some states have already started taking steps to implement their HIX, others have been awaiting the Supreme Court decision.  States cannot wait any longer and should be searching for strategic and technology partners to help build and implement their exchanges and communicate their HIX requirements to health insurers and others.

What this ruling means for Health Insurers. Health insurers must now design and build compliant and scalable solutions that can integrate with the state exchanges.  Each state will present their own unique set of guidelines that insurance companies need to follow.  This represents a significant change from the traditional employer-based, business-to-business model that insurers have generally embraced.  This shift to a direct-to-consumer approach is being likened to the “retailization” of health insurance.

Now that the Supreme Court has communicated the ruling, both states and insurers need to move quickly.  The wait is over.  It’s time.

Learn more about our health insurance exchange and eCommerce solutions or contact me directly via email at brock.muir@rosetta.com.