Mike Sullivan is starting to feel better about the health insurance exchange system being created by the Patient Protection and Affordable Care Act (PPACA).
Sullivan is the chief marketing officer at Digital Insurance Inc., Atlanta, a national benefits broker that serves small and midsize employers. When lawmakers were in the legislative laboratory assembling PPACA one undead limb at a time, he had concerns. Now that the monster is lurching about, the concerns are starting to dissipate.
First, exchange creators talked big about the exchanges eliminating the need for agents and brokers. Then creators got a reality check and rushed to say that the exchanges will work with brokers, especially to serve small employers. Then the U.S. Department of Health and Human Services (HHS) and state agencies proposed regulations sketching out what exchanges might actually look like: Pretty much whatever the exchange builder can get past a state's political establishment.
Now many exchange advocates say an exchange will be like a Travelocity website for health insurance, with live humans.
The big question is, "who's going to answer the phones?" Sullivan asked during an interview.
Sullivan believes, hype aside, the real model may be call centers at state departments of motor vehicles (DMVs).
"If our competition is the equivalent of the DMV at the exchange level, bring it on," Sullivan said.
Jordan Battani, a principal in the San Francisco office of Computer Sciences Corp., said there is still a noticeable lack of clarity about the exchanges.
"Who builds them?" she asked. "Who uses them? There's a lot of learning that's going to happen in the next 18 months."
