Choice and Design in the State Health Insurance Marketplaces

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<p>With the new state and federal health insurance marketplaces now beginning to overcome their initial challenges, two new issue briefs from The Commonwealth Fund take a look at what states are doing to ensure that consumers will find health plans that satisfy their needs and preferences. </p><p><a href="/publications/issue-briefs/2013/dec/how-are-state-insurance-marketplaces-shaping-health-plan-design">How Are State Insurance Marketplaces Shaping Health Plan Design?</a> By Sara Rosenbaum, Nancy Lopez, Devi Mehta, Mark Dorley, Taylor Burke, and Alicia Widge </p>
Part of states' roles in administering the new health insurance marketplaces is to certify the health plans that are offered to consumers. In this brief, George Washington University's Sara Rosenbaum, J.D., and colleagues examine how states that are running their own marketplaces and those that are operating them in partnership with the federal government are using the flexibility they have under the Affordable Care Act to shape health plans that are being sold to consumers. The analysis focuses on three aspects of certification: adequacy of provider networks; inclusion of essential community providers; and benefit substitution, which allows plans to offer benefits that differ from a state's benchmark plan. </p>
<p><a href="/publications/issue-briefs/2013/dec/what-states-are-doing-simplify-health-plan-choice-insurance">What States Are Doing to Simplify Health Plan Choice in the Insurance Marketplaces</a> By Christine H. Monahan, Sarah J. Dash, Kevin W. Lucia, and Sabrina Corlette </p>
To optimize the purchasing experience in the marketplaces, states set uniform coverage levels for health plans and provide consumers with tools to explore their options. This brief examines the policies set by some state-based marketplaces to simplify plan choices: adopting a "meaningful difference" standard, limiting the number of plans or benefit designs insurers may offer, or requiring standardized benefit designs. Eleven states and the District of Columbia have taken one or more of these actions for 2014, though their policies vary. </p>
<p>Over the coming weeks and months, The Commonwealth Fund will provide regular updates and analyses of the insurance marketplaces and consumers' experiences throughout the open enrollment period. And be sure to explore our <a href="~/link.aspx?_id=12838A3B138F456D8AC955E4202C70E6&_z=z">interactive marketplace map.</a></p>