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New health insurance exchanges should be independent, aim for level playing field
Date:9/29/2010

New York, NY, September 30, 2010A new report from The Commonwealth Fund provides recommendations for state and federal policymakers as they design and implement the new health insurance exchanges which are a key element of the Patient Protection and Affordable Care Act (ACA). The state-based exchanges, to be set up by states and the federal government to provide a health insurance marketplace with subsidized health insurance for small businesses and individuals without employer or public coverage, will play a major role in enhancing many Americans' access to health insurance coverage when they are fully implemented in 2014.

The report by Timothy Stoltzfus Jost, Professor of Law at the Washington and Lee University School of Law, Health Insurance Exchanges and the Affordable Care Act: Eight Difficult Issues, examines issues that policymakers will grapple with as they work towards implementing the exchanges, and provides detailed recommendations to improve affordability and access to coverage purchased through the exchanges. These include how exchanges should be set up and governed; how they can avoid adverse selectionor having a disproportionately large share of high-cost enrollees, leading to unaffordable premiums within the exchangeand how to reduce administrative costs.

The author's recommendations include:

Governance

  • In each state, the exchange should be placed within an independent agency, with a governing board that includes representatives of state agencies with which the exchanges must work, and others with relevant expertise.
  • Management of the exchanges should be apolitical and professional.

Adverse Selection

  • To the extent possible, state regulation of the individual and small group markets should be identical inside and outside the exchanges.
  • The U.S. Department of Health and Human Services should design a sophisticated but practical risk-adjustment sy
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Contact: Mary Mahon
mm@cmwf.org
212-606-3853
Commonwealth Fund
Source:Eurekalert

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