Consumers at an insurance forum in Minot Thursday didn't come to champion health-care benefit exchanges, but if the law insists on exchanges, they prefer the federal government to remain as much out of the mix as possible.
The North Dakota Insurance Department sponsored the meeting, conducted for the state by a representative of Odney, a private firm. The purpose was to gather public input related to establishment of health-care benefit exchanges under the federal health-care reform bill.
Information from meetings around the state will be presented to legislators, who will decide when they meet in November whether to set up a state-run exchange or turn operation over to the federal government. The feeling was strong at the Minot meeting, attended by about a dozen people, that the state operate the program.
"No matter who operates the exchange, the costs are going to be recouped. The state of North Dakota has a better chance to control those costs than if they let the federal government do it," said Rep. Bob Frantsvog, R-Minot, one of three legislators at the forum.
Others at the meeting also voiced concern about the program differences in areas where federal and state governments already are involved, such as Medicaid. The state is the better choice to work at cooperation among the programs in an exchange, they stated. The consensus also was that the state could operate an exchange more efficiently.
One consumer noted that she doesn't want to see billions of dollars invested in a program only to have it fail, and she has concerns for the feasibility of exchanges. Failure of an exchange could devastate many people who come to rely on it, she said.
Rep. Roger Brabandt, R-Minot, said his biggest concern is the intrusion of government.
"I want the federal government and the state government out of my life. I think this whole thing is a joke," he said.
Sen. Oley Larsen, R-Minot, voiced a similar concern about the intrusion in forcing citizens to buy health insurance.
There was some concern expressed, too, at the meeting about having to divulge private information, such as income, to get information or sign up through an online exchange. Concerns were raised about the potential for longer waits for healthcare and the sustainability of rural services.
There was support for both maintaining health insurance options outside the exchange and having access to insurance agents to help in the process of buying through an exchange.
"If I feel frustrated and overwhelmed by it, I am more apt to walk way and just pay the penalty," one consumer said. "It needs to be easy to use and simple to understand."
While some participants indicated the current health-care program is fine, others identified problems ranging from mandatory coverages that drive premiums up to cost pressures on employers to provide the coverage.
"I don't know that this is the right thing, but something has to be done," said Louis Pinkerton, a Minot veterinarian. "Not doing anything is not going to get us anywhere."
"It doesn't matter if it's an exchange or free market, it's all about the money," said one consumer who listed affordability as the driving factor in whether people buy insurance and whether business provide insurance.
There were concerns about whether the exchange will be affordable.
James Bierschbach, a Minot insurance agent, said under the scenario that he has seen, a low-cost plan for a 25-year-old male through an exchange would cost $138 a month. He said he can sell a better plan for $84 a month now. He voiced concern that people looking to the exchange alone will shop online for price and end up with inadequate coverage.