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Q&A: A Payer CEO on the New Healthcare Market

Scott Mace, for HealthLeaders Media, July 3, 2012

A few hours after the U.S. Supreme Court issued its decision on the Patient Protection and Affordable Care Act, Brad Wilson, president and CEO of BlueCross BlueShield of North Carolina, the state's leading insurer with 3.6 million customers, spoke by phone with HealthLeaders Media Senior Technology Editor Scott Mace.

HealthLeaders Media: A number of Americans will choose to pay a penalty to the IRS rather than purchase health insurance. Are you concerned about that?

Brad Wilson, BlueCross BlueShield of North Carolina: Let me give you just a little context. After I became CEO two and a half years ago, I spent a lot of time traveling around, right in the aftermath of the passage of the bill, and a long time before lawsuits were filed and there was a lot of focus on the Supreme Court ruling. The point that you're making has been around since that time. In North Carolina, the employers that I'm talking to, now that we have clarity and certainty as to what the law is, many, many employers will in fact do the math and will make a business decision about what is the most economically effective thing that they should do, as well as how that relates to the retention and the recruitment of the type of workforce that they need.

What I have heard is many, many employers will continue to value health insurance as a part of their benefit offering, because they believe that will make them more competitive, whatever their marketplace is, because it is a recruitment and retention tool, as well as a tool by which their workforce can remain and achieve greater things. There are however a number of employers—they seem to be more of the smaller employers, not just those under 50 who are exempt from the law—but smaller employers that are going to be driven more by the economic calculus than by the benefit calculus. Now, is that a concern? I don't believe the number is going to be great enough that it would create a market disparity, if you will, such that as the state's largest health insurer we would think it would cause the market to dramatically tilt.

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