States across the country are actively evaluating how exchanges can and should work at the state level. State policymakers are convening working groups and public-private committees as well as composing white papers and draft legislation. They expect to receive federal exchange planning funds soon. In order to help guide this work, the State Coverage Initiatives program has partnered with Bob Carey, formerly of the Massachusetts Connector, to publish “Health Insurance Exchanges: Key Issues for State Implementation.”

The SCI issue brief provides guidance on the following questions:

• Should states establish their own exchange or use the federal fall-back option?
• Should states establish regional or multi-state exchanges?
• What is the right way to govern and administer the exchange?
• How can states minimize adverse selection?
• What is the role of brokers and navigators in the exchange?

It also delves into how those implementing an exchange can address the following issues:

• Eligibility and enrollment;
• Benefit levels and design;
• Carrier and plan selection; and
• Premium collection and tracking.

This publication adds to SCI’s growing collection of meeting materials and publications on health insurance exchanges produced in 2010. In January, SCI co-hosted a national meeting in Boston that gathered lessons learned from the Massachusetts Connector. SCI also published “Preparing for Health Reform: The Role of the Health Insurance Exchange” in January, and followed up with a related webinar in March. In August, SCI published “Health Benefit Exchanges: An Implementation Timeline for State Policy Makers” and “State Implementation of National Health Reform: Harnessing Federal Resources to Meet State Policy Goals.” In addition, SCI has provided customized technical assistance to policymakers in several states as they make decisions about their own exchanges. To request technical assistance for your state related to exchanges, click here.



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