Buttorff Christine, Nowak Sarah, Syme James, Eibner Christine
Rand Health Q. 2017 Jan 13;6(2):2. eCollection 2017 Jan.
Private health insurance exchanges offer employer health insurance, combining online shopping, increased plan choice, benefit administration, and cost-containment strategies. This article examines how private exchanges function, how they may affect employers and employees, and the possible implications for the Affordable Care Act's (ACA's) Small Business Health Options Program (SHOP) Marketplaces. The authors found that private exchanges could encourage employees to select less-generous plans. This could expose employees to higher out-of-pocket costs, but premium contributions would drop substantially, so net spending would decrease. On the other hand, employee spending may increase if, in moving to private exchanges, employers decrease their health insurance contributions. Most employers can avoid the ACA's "Cadillac tax" by reducing the generosity of the plans they offer, regardless of whether they move to a private exchange. There is not yet enough evidence to determine whether the private exchanges will become prominent in the insurance market and how they will affect employers and their employees.
私营医疗保险交易所提供雇主医疗保险，融合了在线购物、更多的保险计划选择、福利管理以及成本控制策略。本文探讨了私营交易所的运作方式、它们可能如何影响雇主和员工，以及对《平价医疗法案》（ACA）的小企业健康选择计划（SHOP）市场的潜在影响。作者发现，私营交易所可能会鼓励员工选择福利较低的保险计划。这可能会使员工面临更高的自付费用，但保费缴纳会大幅下降，因此净支出会减少。另一方面，如果雇主在转向私营交易所时减少其医疗保险缴费，员工支出可能会增加。大多数雇主可以通过降低所提供保险计划的福利水平来避免ACA的“凯迪拉克税”，无论他们是否转向私营交易所。目前尚无足够证据来确定私营交易所在保险市场是否会占据显著地位，以及它们将如何影响雇主及其员工。
