Pub. 11 2016-2017 Issue 1

May/June 2016 27 Extraordinary Service for Extraordinary Members. resulting in significant losses for most insurance companies participating in the ACAMarketplace. In fact, 12 of the ACA’s 23 co-ops have either closed or will cease to exist by the end of 2016. The failure of the government to fully fund risk cor- ridors played a key role in the demise of the co-ops, including CoOportunity Health, which sold individual policies on the Marketplace in Nebraska and Iowa. What the ACAGetsWrong—andWhat CanBe Done to Fix It • OpenEnrollment (OE) andSpecial Enrollment Period (SEP)— These need stronger oversight to prevent people from signing up for coverage, obtain- ing expensive medical care, and then dropping cover- age once their treatment is complete. • Risk pool— This needs to be as large as possible and the age-rating slope needs to be steeper—more of the young and healthy need to enroll, not just the old and sick. • The system is too centrally controlled. States need to be given more control over benefit design. Even Canada, with national health care, uses its pro- vincial governments to set benefits. The bottom line is that meaningful and effective change to the U.S. health care system through legislation can only go so far—and as you can see, often brings about negative consequences of its own. Meaningful change is possible, however. When insurance companies, health care providers, and patients work together as a team tomake sure people get the right health care service in the right care setting and at the right time, patient outcomes and satisfaction improve, and costs are reduced. Better com- munication and coordination is needed so that everyone un- derstands how to avoid unnecessary emergency room visits, makes full use of primary care and preventive services, and learns how to properly adhere to their medications. It is these types of partnerships that have the most po- tential for fundamentally changing the health care system and making health care (and health care insurance) more accessible and affordable for Americans.  Pat Bourne is senior vice president of sales and account services and product development at Blue Cross and Blue Shield of Nebraska. For more than 20 years, the Nebraska Bankers Association has worked with Blue Cross and Blue Shield of Nebraska to provide NBA members with the security and peace of mind that comes with Blue Cross and Blue Shield of Nebraska healthcare coverage. If you’re interested in learning more about the Blue Cross and Blue Shield of Nebraska healthcare plans available to NBA members, contact Karen Coufal at the NBA at 402-474-1555 or karen.coufal@nebankers.org.