Project for Health Insurance Exchange Education

The Project for Health Insurance Exchange Education (PHIXE), launched in 2011, seeks to harness the potential of state health insurance exchanges established under the Affordable Care Act (ACA).

Health care exchanges are a key provision within the ACA which use properly structured competition—the one mechanism identified by independent analysts to lower health insurance premiums across the board—to maximize health insurance coverage, reduce costs and improve quality of care.

The Congressional Budget Office concluded that an exchange’s pooling of a large number of insurance buyers, combined with subsidies for low-income buyers, could exert competitive pressure on health plans to constrain their prices. In an analysis of a Wisconsin exchange, MIT Professor Jonathan Gruber estimated that this competition effect would lower premiums by 7.5%.

A central goal of the project is to educate state policymakers about how creating an exchange whose pool of buyers is (1) average in risk, (2) very large in size, and (3) incentivized to choose low-cost health plans can be a powerful vehicle for enabling market forces to put strong and enduring pressure on health care insurers and providers to lower costs and enhance quality.

Another project goal is to help policymakers understand how exchanges can improve addiction treatment. These strategies include adopting smart enrollment procedures for state parolees, creating a sound relationship between Medicaid and the exchange, and rethinking the interaction between insurance and stand-alone treatment programs.

During the project, Community Advocates Public Policy Institute staff will:

Hold educational meetings and in-depth seminars with advocates and policymakers about the ACA, exchanges in particular, and how exchanges can lower costs and improve addiction treatment; and
Assist state policymakers who are seeking to design exchanges—in particular, Small Business Health Options Program (SHOP) exchanges—that effectively use competition to lower insurance costs, potentially by even more than 7.5%.

The Project for Health Insurance Exchange Education is funded by the Open Society Foundations.

News

Supreme Court Decision on the Affordable Care Act

On June 28, 2012, the Supreme Court of the United States upheld most of the Affordable Care Act, though its decision allows states to choose whether to expand Medicaid. Community Advocates Public Policy Institute's Senior Fellow, David Riemer, stated: "This decision is a big victory for the millions of uninsured Americans who will gain affordable health coverage with expanded benefits..." and "We should specifically focus on expanding Medicaid to the population that remains uninsured below 133% of poverty, which the Affordable Care Act allows Wisconsin to do in a way that actually lowers overall state Medicaid spending."

Community Advocates previously submitted three amicus briefs (friends of the court filings) to the Supreme Court, and was the only Wisconsin-based advocacy organization to participate in the case. The briefs contended that (1) the individual mandate does not violate the Commerce Clause; and (2) the ACA’s expansion of Medicaid does not create “onerous conditions” on states (and in fact imposes no burden at all); and (3) if the individual mandate is struck down, the balance of the ACA should stand.

PPI's Bare Testifies at State Senate Hearing on ACA

On Friday, September 21, Mike Bare, PPI's Research and Program Coordinator, testified before the State Senate Health Commitee on why Wisconsin should establish and operate state-based health insurance exchanges and why it should expand Medicaid. Read or listen to a story about the hearing from Wisconsin Public Radio here, or watch the hearing in its entirety here.

PPI Advocates for an Expansion of Medicaid that Will Fill Eligibility Gaps, Save State Taxpayers Millions of Dollars, and Help Employers Avoid a Federal Tax Increase

According to a Public Policy Institute analysis, Wisconsin employers will pay a a big new tax if the Governor and Legislature fail to expand BadgerCare by filling its gaps in eligibility. Doing so will also cover 170,000 Wisconsinites and save state taxpayers millions of dollars. View the press release and letter to the governor and legislature here.