Your Source for Health Reform

Topic: Health Insurance Exchange



A key concept of the reform model adopted by the ACA is that states would have centralized markets offering a variety of qualified health plans to consumers, along the lines established in Massachusetts in 2006. Although the term was common during the campaign to enact reform, the exchanges are now more often called health insurance marketplaces.


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Medicare Part D’s Lessons for the New Marketplaces

This June 2013 brief from the Robert Wood Johnson Foundation describes the lessons learned from the implementation of the Medicare Part D program as they apply to the expansion of coverage via the new health insurance exchanges and Medicaid. (more…)

State Policy Decisions in Exchange Implementation

This February 2013 brief from the Center on Budget and Policy Priorities highlights the many areas in which a state has significant flexibility to customize its exchange to best meet the needs of its residents. (more…)

Examples of Consumer-Friendly Standards for the Exchange

The way an exchange implements it standards for qualified health plans will have a significant impact on the ability of these plans to meet the needs of consumers and small businesses. This January 2013 resource from Families USA outlines the minimum QHP standards required by the ACA and provides examples from eight state-based exchanges on how to implement those standards in a consumer-friendly way.

Creating A Usable Measure Of Actuarial Value

This January 2012 report from Consumers Union explains how actuarial value will be employed under the health reform law, the definitional and measurement issues associated with its use, and how to craft a measure that is usable by consumers.

Affordable Insurance Exchanges Guidance

This detailed guidance issued in January 2012 by the Department of
Health and Human Services provides a framework and basic roadmap for states considering a State Partnership Exchange and describes how HHS will work with states independent of State Partnership Exchange.

Illinois State Partnership Exchange Blueprint

Illinois’ November 2012 application to the federal government for a partnership health insurance exchange.

Affordable Care Act: Strategies for Effective Implementation

This presentation by Andy Hyman of the Robert Wood Johnson Foundation was part of the October 2012 “Building Consumer-Oriented Health Insurance Exchanges; Progress and Opportunity in the Midwest” conference. See other conference materials.

State Responsibilities in a Partnership Exchange

This October 2012 report for states that choose to establish an exchange in collaboration with the federal government is part of a series of briefs from Families USA on implementing health insurance exchanges.

The Summary of Benefits and Uniform Glossary

All insurance companies and group health plans must use the same standard SBC form to help you compare health plans. You have the right to receive the SBC when shopping for or enrolling in coverage or if you request a copy from your issuer or group health plan. These are linked from HealthCare.gov. HealthCare.gov will also provide consumers with a new resource, in the form of an online glossary, to help them understand some of the most common but confusing jargon used in health insurance.

Blueprint for State-based and State Partnership Exchanges

This HHS document is the comprehensive roadmap for a state’s application for approval of its planned state-based or partnership exchange. State applications were to be submitted to HHS by November 16, 2012 for review and approval.

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