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Setting Up Health Insurance Exchanges: How to Overcome Eight Difficult Issues

A new Commonwealth Fund report offers recommendations for state and federal policymakers as they design and implement health insurance exchanges, which are a key element of the Affordable Care Act. The state-based exchanges, to be set up by states and the federal government to provide a health insurance marketplace with subsidized health insurance for small businesses and individuals without employer or public coverage, will play a major role in enhancing Americans' access to health insurance coverage when they are fully implemented in 2014.

The report by Timothy Stoltzfus Jost, professor of law at the Washington and Lee University School of Law, examines issues that policymakers will grapple with as they work to implement the exchanges and provides detailed recommendations to improve affordability and access to coverage purchased through the exchanges. These include how exchanges should be set up and governed; how they can avoid adverse selection—or having a disproportionately large share of high-cost enrollees, leading to unaffordable premiums within the exchange—and how to reduce administrative costs. Also see Jost's blog on overcoming barriers to implementing health insurance exchanges.

Join a Nov. 4 webinar on health insurance exchanges with Jost, Michael T. McRaith, director of the Illinois Department of Insurance, and Sara R. Collins, vice president of the Affordable Health Insurance Program at The Commonwealth Fund. Click here to learn more or register.


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