Exchanges

As American workers are increasingly looking to a new range of employer-sponsored retirement products to help guarantee some securely funded golden years, they may be missing out on the advantages of a system they’ve paid into their entire working lives.

Many exchange budgets are being cut at the same time states are struggling to reach their remaining uninsured, and some are looking to brokers to provide assistance in filling that gap.

The Advance Premium Tax Credit probably contributed to an expansion in health insurance coverage last year, but some taxpayers may still lack access to affordable health plans.

In recent years, a number of states have begun toying with the idea of creating their own retirement systems to help smaller employers provide workers rudimentary retirement savings opportunities.

Although most employers who move to private exchanges are seeing some cost savings below trend in their initial years, that is not sustainable over time, says Rob Harkins, practice leader, private exchanges at Willis Group. For Willis, the exchange is not designed to be a long-term money-saving product on its own, but rather part of a larger program for its clients to manage health and wellbeing.

The fight over the Affordable Care Act in Washington is as fierce as ever, with a Republican budget plan that would repeal the health care law Democrats passed five years ago. In the rest of the country, opposition to the law appears to be easing.

California's struggling to pay for health care for retired state employees, with an estimated $72 billion in medical costs coming in the next 30 years. Gov. Jerry Brown's solution: Make workers start contributing money to pay for the health care they'll need after retiring.

While the Affordable Care Act bans pre-existing condition exclusions, cherry picking and higher premiums for sicker individuals, a 2014 federal discrimination complaint and new study suggest that some public exchange plans have jacked up certain prescription drug prices.

Commentary: CMS has issued a special enrollment period for certain individuals to sign up for health care coverage on the exchanges. Blogger Craig Hasday wonders if the administration's leniency is also hurting its credibility.

Worksite clinics and private exchanges might appear to be mutually exclusive approaches to rising cost pressures, yet they can be integrated to achieve the same goal – improved health outcomes and lower health care cost trend.