Nobody wants to spend a lot of time and energy — and taxpayer money — and end up where they started. But that’s what could happen with one of the principal elements of health reform, the “exchange” or “gateway.”
Legislators are designing this new insurance marketplace to protect consumers from many of the pitfalls and inequities in the current system. But even as they focus on the details of how the marketplace will work, senators have indicated that they would allow insurers to continue operating outside it, much as the health-insurance lobby has sought.
This is an great example of the kind of DC shenanigans that cause so much animosity, doubt, and skepticism amongst consumers that the current reform package will have its intended (or implied) impact.