Health insurance exchanges – a key element of the Patient Protection and Affordable Care Act (ACA) – are intended to help individuals and small employers buy affordable, high-quality health insurance. Beginning in 2014, these new entities will offer consumers a choice of plans, establish common rules regarding the offering and pricing of health plans, and provide information to help consumers better understand the options available to them. The law gives states considerable flexibility in structuring its exchange, including issues related to governance structure, operations and financing of the exchange.
To assist states with the design of a health insurance exchange,the National Academy of Social Insurance (NASI) recently released a legislative toolkit – the first product of a broader NASI project funded by the Robert Wood Johnson Foundation – to provide technical assistance to states developing exchanges. The toolkit offers language for legislative options for key areas, including governance, establishment of SHOP exchanges for small employers, eligibility determination and enrollment, certification of qualified health plans and coordination with Medicaid and the Children’s Health Insurance Program (CHIP).
- Lee Goldberg, Director of Health Policy, National Academy of Social Insurance
- Deborah Chollet, Ph.D. – Senior Fellow, Mathematica Policy Research
- Renée Landers, J.D., Professor of Law and Faculty Director, Health and Biomedical Law Concentration, Suffolk University Law School
- Norman Thurston, Ph.D., Health Policy & Reform Initiatives Coordinator, Utah Department of Health
- Kelly Harms, Operations Analyst, Health Insurance Exchange, Oregon Health Authority
Visit the Designing an Exchange: A Toolkit for State Policymakers page on the Robert Wood Johnson Foundation website for a full audio recording from the event.
For more information about NASI’s Health Insurance Exchange Study Panel, please contact Sabiha Zainulbhai, Health Policy Assistant at email@example.com or Lee Goldberg, Health Policy Director at firstname.lastname@example.org. Both can be reached by telephone at 202-452-8097.