The Patient Protection and Affordable Care Act (ACA) and resulting decision-making processes necessary for implementing health care reform have made state-level data and analysis even more crucial to states. Policymakers require good information to make these decisions, and subsequently understand their impact. To help, State Coverage Initiatives partnered with Julie Sonier of the State Health Access Data Assistance Center (SHADAC) and Patrick Holland, formerly of the Massachusetts Health Connector, to publish “Health Insurance Exchanges – How Economic and Financial Modeling Can Support State Implementation.” 

This SCI brief describes some of the issues that states will need to consider as they think about modeling the impact of the ACA in their state, focusing on economic, actuarial, and financial data to provide fact-based foundations for decision-making. The brief will provide guidance on:

• Establishing the scope of analysis – defining a clear set of questions to be answered.
• The modeling approach – identifying how the model is constructed, and what data sources are the most appropriate to use.
• Establishing a baseline – clarifying the impact of policy options evaluated by comparing them to a baseline that depicts what the landscape would look like without any policy changes.
• Inputs to the model – examining which data are most available and appropriate for the model being utilized.
• Actuarial analysis – determining the impact of policy options on private health insurance premiums.
• Financial analysis – understanding the projected costs and revenues needed to implement and administer an exchange.

This publication adds to SCI’s existing collection of meeting materials and publications on health insurance exchanges. In January, SCI also published “Preparing for Health Reform: The Role of the Health Insurance Exchange” 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.” This was followed by “Health Care Exchanges: Key Issues for State Implementation” in September. In addition, SCI 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.