Representative Verla Insko, a former Health Program Administrator, asked during a recent Health and Human Services committee meeting how the Patient Protection and Affordable Care Act (PPACA) would be impacted by the Employee Retirement Income Security Act (ERISA).  What came after was a series of uncomfortable looks from House and Senate members, as well as the experts, and universal acknowledgement that no one really knows.

Under any North Carolina health insurance exchange, health coverage could be expanded in 2017 to cover companies currently under ERISA. However, this could lead to unpredictable and regrettable consequences for the state, above and beyond those currently being addressed in ObamaCare discussions. A practice commonly known as “dumping” would allow ERISA-participating businesses with high-risk pools of employees to disproportionately drop their health coverage and instead pay a penalty to the government. In many cases the penalty fee would cost far less than the mandatory health care coverage for high-risk employees. In turn, this will pollute the state funded health insurance exchanges with many new high-risk individuals, driving up costs for everyone.

Before the creation of a state health insurance exchange shouldn’t we take the time to evaluate who will be dumped by whom, so no one gets their feelings hurt and we aren’t left with the bill.