Obamacare: why the exchanges are government-run

Why does Obamacare (Affordable Care Act) require the creation of government exchanges? Why not allow private sites like ehealthinsurance dot com to sell subsidized plans if they meet the requirements?

Dot Gov Skeptic

Dear Dot Gov Skeptic,

You raise an excellent question!  I’m no computer techie, but I’m guessing that the government felt it had to take the front-and-center role in handling the subsidy calculation and payment.  The grocery store does not figure out who gets food stamps; a government agency does that.  Food stamps would actually be easier to figure out than the health insurance exchange.  When you go to healthcare.gov, you are doing three complex things:

1)      Selecting a plan that has been verified to meet health reform standards.

2)      Giving income information so that subsidies can be calculated.

3)      Telling the government which carrier should receive your subsidy.

It does this in real time and creates a tracking system for the subsidies to go from the government to your carrier.  Granted, the site has done none of these things smoothly or quickly.

In the future, technology (in the form of a better government-run website or a private site) could invent new ways for us to enroll in qualified health plans and receive the subsidy.  I’d certainly like to think that the future will make things better and simpler.

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.