On Saturday, roughly 100 students, professors and professionals gathered at the Yale Law School for a crash course on the implementation of heath insurance exchanges.
Health insurance exchanges — which are now enrolling consumers under the Affordable Care Act — are online marketplaces where individuals can research and purchase health insurance. Saturday’s conference, entitled “Heath Insurance Exchange Implementation: Early Challenges and Opportunity” featured panels on how the exchanges work, on the current status of implementation and on the roles and responsibilities of state and federal officials across the different exchange models.
The event was organized by the Yale Health Law and Policy Society, an organization founded last spring by students Gabe Scheffler LAW ’14 and Sarah Grusin LAW ’14. Grusin said the society had the idea for the conference last year and wanted to hold it at a time when it would be relevant — when people would start enrolling in the exchanges under Obamacare.
“The exchanges are a big part of health reform, and it does not seem that people have a great understanding of them, [so] we want to create a more in-depth discussion,” Grusin said. “Another [aim] is to prompt legal research about the challenges the exchanges present.”
Yale Law School professor Abbe Gluck, who moderated the third panel, entitled “Cooperative Federalism in Action,” said the exchanges represent a fundamental landmark in health care policy. These exchanges are the means by which the federal government is helping six million Americans to buy insurance this year, she said.
But health care exchanges are not without challenges, she said. Such obstacles include both technical difficulties and political resistance stemming from divisions among party lines and confusion about the different exchange models — which include state agencies, federal government agencies and hybrid partnerships between the two actors.
Sarah Dash, a research fellow at Georgetown University Health Policy Institute’s Center on Health Insurance Reforms, said the exchanges allow for a certain amount of consumer independence, but also require more interaction between consumers and state or government officials.
The present situation poses many questions for the future, she added.
“At the end of the day is health care going to become better?” she asked. “Will it be accessible, affordable, accountable?”
Mark Hall, a professor at Wake Forest University School of Law who spoke on the first panel, said that in order to understand health exchanges, one must trace the history of different insurance systems, including those that have failed. He added that the health care sector is complicated by a skewed distribution of spending: The top 1 percent of the population accounts for up to one-fourth of total health care expenditures, he said.
Christine Monahan LAW ’16, another conference organizer, said this conference is important to the progress of the Yale Law School in the relatively unexplored field of health law.
“Yale Law School is [gradually] building up a health law program,” Monahan said. “This is a great first step in establishing Yale’s credentials in this area more broadly.”
This semester, Gluck is teaching a seminar in health law, which Monahan said is eliciting great interest from the student body.
Grusin said that the bulk of the attendees at the conference were students from Yale’s different graduate schools, though some professors, attorneys and government workers from the New England area also attended.
Attendees interviewed said they appreciated the wide range of speakers from different disciplines selected for the conference, which allowed them to gain an in-depth understanding of the exchanges.
Ffyona Patel SPH ’14 said she appreciated the different perspectives presented by the panelists because they allowed for a detailed and complete picture of the current situation.
“I [was] interested in this conference because it deals with the nitty-gritty of the issue,” Patel said. “And because the panels were set up to be interdisciplinary, it was especially nice to see some [Masters of Public Health] panelists.”
Four students interviewed said that a conference at Harvard Business School on this topic had been scheduled for the same day, but they chose to come to Yale’s event instead.
Open enrollment for the health care exchanges, ends on March 31.