Humana CEO Bruce Broussard runs the fourth-largest health insurance group in America. He has spent more time engaging with the provisions of President Obama's health care reform than just about anybody else. And even he isn't sure what the law's going to look like or what its impact will be over the next 7 years.
"We have not seen all the details around health care reform. The implementation is going to be at the end of the year. In fact, people will probably start buying [insurance] in the fourth quarter or so. We are asking for some more detail. The second aspect is that it is such a complicated bill. There are so many interrelated details that I don't think anyone knows all the different parts. Our concern is about what we don't know."
Broussard expects prices to to go up, particularly for the young healthy population. That's a fact that hasn't totally sunk in for the public and businesses, which worries the Humana CEO.
"I don't think it's been talked about enough in public. I think the communication of the reform has been around the expansion of the coverage. But I do not see a real, large conversation around what the impact is on the public."
He calls pricing the biggest issue, and says that we can expect a "bumpy road" until the details get hashed out. And there are lots of details.
There's also uncertainty about what health care exchanges — a set of regulated and standardized health care plans which can be federally subsidized — will look like. Some will be run by states, some in partnership with the government, meaning there could be wide variety of different rules.
They're supposed to be up and running by January 1st, 2014, but Broussard says there's still a tremendous amount of detail to be worked out, which could cause delays.
The hospital industry has already massively consolidated ahead of health care changes.
Other businesses, however, are unprepared. After all, there has been little discussion of the impact since the Supreme Court upheld the law.
In the long run, Broussard expects that the law and technology will work to reduce cost long term. But for now , we can expect " troubled times."
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