A previous entry reported and discussed the lackluster — basically non-existent — results of the Utah Health Exchange, and promised to explain why unsubsidized exchanges are unlikely to attract significant numbers of beneficiaries from the small-group market. The answer, I believe, is pretty straightforward: The administrative costs of operating an exchange plus the administrative costs to a small business of migrating to the exchange are almost certainly greater than the administrative costs of participating in the traditional small-group market (or taking account of other “work arounds” promoted by some insurance producers). Therefore, unless an exchange is subsidized from non-exchange sources (as per Obamacare), it will not attract many participants.
While straightforward, this conclusion is not necessarily intuitive.
Read the entire column (and comments) at John Goodman's Health Policy Blog.