Health IT investors ID Affordable Care Act's winners and losers

Consumers and small businesses will be among the winners as provisions of the Affordable Care Act continue to roll out, health technology investors told VentureBeat just hours before new health insurance exchanges opened nationwide.

Consumers will benefit from having more choices for health insurance plans, said eHealth CEO Gary Lauer, whose company is a health insurance marketplace. Without the fear of being unable to replace employer-provided health insurance, he added, would-be entrepreneurs will be more likely to start their own businesses, according to VentureBeat.

Although some critics have speculated more employers will drop group health plans and push employees toward the health insurance exchanges, Kocher thinks the ACA's individual mandate will put more pressure on employers to provide healthcare coverage.

The comments came during an informal dinner meeting in San Francisco with Farzad Mostashari (pictured right), outgoing (and now furloughed) national coordinator for health information technology.

The investors also identified probable losers under healthcare reform, including new, small healthcare insurers, medical device companies and drug companies as physicians order fewer tests and prescribe fewer drugs under a value-based healthcare model. 

Last year, in a FierceHealthIT special report on the Supreme Court healthcare reform ruling, we predicted med device makers would be winners under reform--with a caveat. 

"Medical device and diagnostics that save the system money but keep care quality strong will gain under the new system," our editors wrote. "The least invasive device, treatment or diagnostic that accomplishes the goal of treating a patient effectively at a lower cost--and has the data to back that claim up--will end up the winner." 

The view of winners and losers also depends on the type of consumer or business involved, reported the Post and Courier in Charleston, S.C.

Consumers earning up to 400 percent of the federal poverty level and without employer-sponsored health insurance will qualify for government subsidies to help pay premiums for policies secured through the insurance marketplace, the newspaper noted.

Those falling below the federal poverty line but with incomes too high to qualify for Medicaid will lose out, the paper added. South Carolina is among the states rejecting federal money to expand Medicaid.

For more information: 
- read the VentureBeat article
- here's the Post and Courier article

Suggested Articles

Payers and providers have made significant investments in digitizing the healthcare system but have yet to see a return on that investment.

Fewer than 4 in 10 health systems can successfully share data with other health systems, which presents a number of challenges.

As telehealth programs continue to expand, it’s crucial to understand how facility management will shift with these advancements in healthcare.