The emerging state insurance exchanges suggest that states’ rights are alive and well.
As the implementation of portions of the Patient Protection and Affordable Care Act approaches, state exchanges are beginning to take form and substance. The Commonwealth Fund surveyed all 50 states and the District of Columbia to see how things were going, and found plenty of diversity among the characteristics of the various exchanges.
1. States are deciding how to fund their exchanges, and some will assess insurers to do so. The report says:
Seven states and the District of Columbia remain undecided on their long-term revenue source; most of the remaining states will assess insurers that offer coverage in the exchanges. State officials reported that decisions in these areas often reflected compressed timelines, political realities, and the state’s long-term vision for the exchange.
3. Insurers are going to have to be flexible, and get used to increased government oversight, when it comes to meeting the needs of small business employees. The report says:
5. State-run exchanges confer considerable power on state officials to design their exchanges, and these states are, in general, moving quickly to complete their exchange structure by the October deadline. The report says: