Health insurance exchanges to add coverage for 25 million new customers

October 2, 2012

Twenty-five million new health insurance customers aren't expected to overwhelm the system or drive up costs immediately after obtaining coverage.

Health insurance exchanges are expected to add 25 million newly insured patients to the U.S. health system.

But those new customers aren’t expected to overwhelm the system or drive up costs immediately after obtaining coverage, according to a new report from consulting firm Pricewaterhouse Coopers (PwC).

“Providers should prepare for an increased number of patients who may arrive for their first checkup in years, some with a pent-up demand for services and undetected illnesses,” according to the report.

Although these newly insured patients could represent new business opportunities for primary care physicians, they also could bring added responsibility.

The report warns that this influx of new patients could accelerate new expectations for medical care: more online offerings, greater transparency, and an increased focus on customer experience.

Health insurance exchanges, essentially online marketplaces where consumers can shop for insurance policies, were among the major components of the Affordable Care Act. But progress on exchanges has been slow.

More than three-dozen states appear unprepared or unwilling to set up their own exchanges, and many are likely to leave it to the federal government, the Washington Post reported.

States have until November 16 to notify the Department of Health and Human Services on whether they plan create their own exchanges or collaborate with the federal government, according to the PwC report.

Among the 25 million people expected to gain coverage through exchanges, the median age is 33. They’re mostly white, and they’re less educated than the currently insured population. Less than one-fourth of the exchange population is expected to consist of college graduates, compared with 40% of the currently insured population, PwC said.

Although the effect insurance exchanges will have on medical providers is unclear, exchanges are expected to be a boon to insurance companies. Exchanges represent an estimated $205 billion in health insurance premiums by 2021, according to the report.