In the short term anyway, all these health insurance companies should theoretically be hiring - a lot - to support the influx of additional people. Plus, while insurance companies will probably not be able to raise premiums a ton, the government is giving individuals tax rebates for buying insurance, but I don’t think they’re forcing insurance companies to lower premiums (yet), though I’m guessing they’ll at least have to cap them and offer a standard defined benefit, similar to the Medicare model. And, many people who don’t have insurance don’t have it because they don’t yet need it (at least, that’s true for many young people who don’t have it), so I think the idea is that with a healthier population now required to have health insurance, companies will make more in the short term until their population ages and/or sickens, which is probably one of the reasons for encouraging preventive care by making it free (I think the preventive care will only apply to Medicare-eligibles for now).
As for hiring, the regulations are coming out; however, the federal government will probably be releasing sub-regulatory guidance soon that will require quite a bit of implementation. Using Medicare as a model, companies will need:
Marketing personnel to comply with new marketing guidelines (CMS considers policy info “marketing,” including things like your huge policy book, summary of benefits/annual enrollment guides, etc.
Reporting specialists (including claims, prescription drug data, medical use, etc.)
IT infrastructure
Grievances, appeals, pre-auths, other utilization management specialists
Benefits specialists
Fraud, waste & abuse specialists
Network contracting specialists
Added contacts with drug manufacturers
Coordination of benefits personnel
Added legal personnel and lobbyist relationships
And, assuming that private companies will be providing the State Insurance Exchanges, they’ll need to staff up for that and will have to figure out how to coordinate with Medicaid.
There are also tons of other ways insurance companies, state programs, corporate assistance programs and other organizations will have to coordinate.
It’ll be interesting to see what happens and how things go with respect to implementation. Plus, with the recent ruling that companies can be considered persons, I wonder how that’ll effect the healthcare companies lobbying Congress. The government itself will also need a ton of additional people to handle things like call center, review marketing for compliance, perform audits on health plans, create and clarify policy, check networks, etc.
As someone who helped implement several Part D plans during the initial launch of the program, this is kind of a wet dream for me - so much to learn and so complicated, which I love. It seems like there’s so much opportunity (for now, anyway) to learn and provide expertise. There’s also a lot of opportunity for failure, though.
