I am troubled at NFIB supporting the implementation of Health Insurance Exchanges. We are a newer member of NFIB. We are a small business. We are also health insurance brokers. Health Insurance Exchanges would attempt to do what we already do. As history has shown, government bureaucracies never operate effectively. They also never provide the level of service found in the marketplace. A Health Insurance Exchange would put millions of us out of business. Our business was started in 1977 and has helped thousands of individuals and small businesses meet their coverage needs. We have seen the downturn of the healthcare industry over the years, most of it by government intrusion. Adding more of the problem to fix the problem doesn't make sense.

I'm asking that NFIB reconsider it's stance on this issue. If it really is for small business then it wouldn't support Health Insurance Exchanges. Let's work on REAL healthcare reform. I'm looking forward to discussion on the subject. Thanks.

Yes, I agree Health Insurance Exchanges are a very weak solution, there is simply no competion in the Market, even the idea of going across state lines, just sends insurance companies to Delaware so it is harder to sue them. NFIB if full of weak ideas, they have understood that Health Care is the number one problem for the last 20 years and have done little to promote real reform.

I am very proud of NFIB and the thoughtful public policy positions that it takes on issues such as health care reform.

I could support health insurance exchanges if the federal government stayed out of managing or over-regulating those exchanges.

Our Chamber of Commerce established a "Health Insurance Trust" The trust is made up of member businesses and their employees who pay into it. The trust board works through a consultant, an administrator and insurance broker/agents like your company Wade.

The trust board shops for "stop loss" coverage that covers the trust beyond what we have built in reserves. As our reserves increase ... our "stop loss coverage" premiums decrease.

We have been able to offer a variety of plans for our business members, and premium increases have remained in the single digets. Yes, we the insured now pay for all of those who are uninsured .. one way or the other because those costs are passed along by hospitals .. etc.

This is how I see exchanges working. I would hope that NFIB would be an "Exchange" .. if that is what they finally end up calling it. That way NFIB members have a way to pool their resources accross state lines.... or select another organization's program.

Keep the federal governemt out of the insurance market .... with the exception of providing a safety need for the most needy. But define the most needy narrowly and leave the rest of us alone.

Competition in the marketplace is the only way of controling costs.

Tax payer subsidized government option is smoke and mirrors and not a competitive option.

Dear Roland,

Thanks so much for your thoughtful comments regarding exchanges. We do see opportunity in a structure like an exchange that could provide greater efficiency, larger pooling and better choice of product. NFIB has long been an advocate and has studied various ways on how to create a more competitive marketplace by opening state boundaries and letting employers join together for pooling power. We do see good ideas in the Senate Finance Committee conversations and will work hard to make sure it will be done the right way. There could be state exchanges, non-profit exchanges or interstate-compact-like agreements, all of which could achieve similar goals. Yes, many of the chambers have been successful in this effort at the state level. There are some federal law changes the private market will need to make this happen but it by no way means the federal government needs to play a large active role. In fact, quite the opposite. What we have said is give us the level playing field and allow the market to work. We like you, are very concerned about the "public plan option" and one that we think could completely erode the private coverage that we know and like today. Cost continues to be lost in the broader discussion and we hope after the Congressional August recess, there will be more attention paid to bringing down overall costs, addressing the cost shifting element, and creating viable markets for anyone who wants to purchase coverage....regardless of the source. That means the individual and small group market issues must be addressed. Fixing these two markets can go a long way to having a more successful and sustainable system. Yes, I agree that a safety net should remain in place for the needy.

Thanks again for your comments, look forward to working this important issue on your behalf.

Healthcare Team, NFIB

Thanks for commenting on the idea of an exchange and the concern that they may take over the role of independent insurance brokers. While NFIB thinks the idea of exchange-like structures could help with pooling and expanded choices, we are not looking to eliminate the role of brokers, and won’t support efforts to eliminate them or prohibit their involvement in any new health insurance exchanges.