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National health care reform carries threat of bureaucracy

Virtual stores where people and small businesses can shop for health insurance plans were a key provision of the national health care reforms passed last year.

Where Pennsylvania's shop will be built, and who will stock and run it have yet to be determined by state officials, including legislators, Insurance Commissioner Michael Consedine and Gov. Tom Corbett's administration.

In fact, leaders have not even decided if they want the hassle of a big new bureaucracy that could cost tens of millions of dollars a year to operate. They could just do nothing and let the federal government step in, Consedine said.

"That's certainly one of the options that we're looking at," Consedine told the Tribune-Review. "More than a few states across the country have indicated they're not going to have a state-based exchange. ... Creating a new bureaucracy carries with it a fairly significant price tag."

The Governor's Office of Health Care Reform estimated that 1.3 million to 2.1 million people in the state will purchase health insurance through an exchange. And by adding a 1 percent assessment to insurance plans sold through the exchange, it could generate between $45 million and $75 million a year for oversight.

All options are on the table as Consedine and his department prepare to host a series of public forums to collect opinions from across the state on the form and function of an exchange. One of the three forums is scheduled for 9 a.m. Tuesday at the DoubleTree Hotel Pittsburgh/Monroeville Convention Center in Monroeville.

"It's not up to me," Consedine said. "We come into this process with everything on the table. That's why these forums are so important."

Health insurance exchanges are a vital piece of the 2010 Patient Protection and Affordable Care Act because the law requires Americans to have health coverage starting in 2014, whether they get it from their employer, the government's Medicare and Medicaid programs, or buy it themselves.

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