If there’s one thing that the left and right can agree about on Obamacare it’s that the employer mandate is bad policy. The health care law’s requirement that companies with 50 or more full-time equivalent workers offer health insurance locks further in place our unique, and idiosyncratic employer-based health insurance system. But just because the employer-based system of health insurance is itself undesirable, doesn’t mean that there’s nothing we can learn from it. After all, it makes sense that if anyone holds the keys to improving the performance of our health care system, it might just be the companies that have been involved in paying for it for over half a century.

A recent report from the Kaiser Family Foundation underscores one such lesson – the growing takeup of private exchanges has the potential to be a catalyst for some major revolutions in our health care system.

In 2014, about 2.5 million people across companies of all sizes will be enrolled in health insurance through so-called private exchanges. These are analogous in some ways to Obamacare’s state and federal-based health insurance exchanges but instead are run by private consultancies like Aon Hewitt or Mercer. While these platforms generally offer a similar “e-commerce” approach to purchasing health insurance – either with a single carrier or multiple carriers offering plans – as the public exchanges do, there remain key differences.

For one, though with some exception, the plans being sold are typically group policies (although the report notes that 100,000 are non-e-broker individual market enrollees through small companies). Moreover, the platforms themselves tend to have a more robust offering of consumer-support tools. These tend to include physician finders, jargon-free questionnaires to help identify the ideal plans (high-deductible plans may not be ideal for a 50 year old, sedentary diabetic, for instance), cost calculators, and often also include access to ancillary offerings like health savings accounts.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary