RM: The rollout of health care reform has created a changing landscape, and different areas are evolving at various rates. What are the most important issues that the Chamber sees as needing to be tackled?

Right now, if you’re a doctor and you want to treat your Medicare patient in another state using telemedicine, you have to be licensed in both states. This is a great example of a regulatory barrier that could use additional flexibility so we can open up these channels of care. —Jennifer Pierotti, director of health policy at the U.S. Chamber of Commerce

JP: In order to keep all of this private-sector innovation going, what sorts of regulatory reforms need to take place? What parts of the Affordable Care Act do we need to address so that employers can keep doing what they’re doing? The Chamber as a whole has a regulatory reform agenda that promotes changes like more transparency and longer comment periods for the regulatory process. Reforms like this are meant to ensure that businesses aren’t battling red tape and can continue to create health care startups and innovate. Much of the health care law was written through the regulatory process, and it went much faster than it should have gone given the complexity and scope of many of these health care regulations. Our main priority right now is reducing the impact of the employer mandate.

RM: Many of our readers would be surprised to know that there are a lot more private health care exchanges than public ones, spawned as business began to move away from defined benefits and toward defined contributions. As business moves from being the sole source of insurance to being a partner with the employees for insurance, what can we expect to see from business in terms of working with their employees to ensure that they have health coverage?

JP: The biggest thing we’re seeing now is the shift to a new consumerism in health care. Despite some of the mandates on the insurance market, employers are looking to how they can use cost sharing to get their employees the best deals and options for coverage. They’re investing in things like health reimbursement arrangements, flexible spending accounts, health savings accounts, and different ways employees can get more bang for their buck. We’re going to see more of that as employees are seen as the consumers, rather than recipients, of health care on a much wider scale.