June 30--One aspect of the Affordable Care Act requires that "health insurance exchanges" be in place by Jan. 1, 2014. Critics, such as Dan Evans, president and CEO of IU Health, say the exchanges will result in employees paying considerably higher health insurance premiums.

"My guess is that far more people will go into the exchanges than anyone anticipated," he said. "And for most employees -- particularly younger, low-risk employees -- the cost of the insurance they will buy in the exchanges will be much higher than what they are currently paying."

State Sen. Vi Simpson said because states have a variety of options related to how they implement the exchange program, it's important now for Indiana's legislators, consumers, insurance companies and health care providers to work together "to make sure we come up with a plan to implement the ACA in a way that meets the needs of Hoosiers rather than depending on the federal government to do the implementation so we can make sure Indiana gets its fair share of dollars."

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State Rep. Peggy Welch said she hopes Gov. Mitch Daniels will work with the Legislature in determining how to best implement the exchange program.

"Up until this point, the governor has asked us to rubber-stamp what he says must be done with the exchanges," she said. "I hope members of the Health Committee, Ways and Means Committee, and Budget Committee will be allowed to give guidance to the governor on how to implement the health exchanges."

Evans said the health care bill allows an employer, if it pays a $2,000 fine, to terminate its employer-provided insurance and allow its employees to go to an online exchange that will operate similar to eBay.

"The employee goes online and types into the system, for example, that he is a 62-year-old male with low blood pressure and wants the least expensive bronze policy; then he receives premium offers from several insurance companies in the exchange," he said.

Evans said the health care legislation will require employers who don't pay a fine to provide a certain level of health insurance to their employees. He said large employers in Indiana have told him they will not be able to afford to provide these levels of health insurance because certain aspects of the bill, such as mandated coverage for children up to age 26 and employees with pre-existing health care conditions, will drive up that cost an average of 10 percent.

Christy Gillenwater, president and CEO of the Greater Bloomington Chamber of Commerce, said local employers will be deciding whether the health care bill will allow them to continue to offer insurance for their employees, or whether they will send them to the health care exchanges to shop for insurance.

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