Designing a Marketplace that Works: Steps to Affordable Coverage

October 22, 2010

The Affordable Care Act (ACA) enacted in March 2010 calls for the establishment of state health insurance exchanges – marketplaces through which individuals and small businesses can purchase affordable insurance. These exchanges must begin operation by January 1, 2014.

Between now and then, both federal and state officials have many decisions to make and many steps to take. States may design and set up their own exchange or opt to let the federal government administer an exchange in their state. They may choose to create two exchanges, one each for the individual and small business insurance markets. They may choose to collaborate with neighboring states to develop regional exchanges. Recently, California became the first state to sign into law the establishment of a state-run health insurance exchange in response to the ACA. Massachusetts and Utah already operate statewide exchanges.

What is the timeline for developing health insurance exchanges? Will states be able to meet the deadline? What happens if a state chooses not to create its own exchange? What are the challenges and opportunities for states and the federal government associated with implementing these provisions of the law?

To answer these and related questions, the Alliance for Health Reform and The Commonwealth Fund sponsored an October 22 briefing. Panelists were: Joel Ario, HHS Office of Consumer Information and Insurance Oversight; Timothy Jost, Washington and Lee University; Michael McRaith, director of the Illinois Department of Insurance; and Terry Gardiner, Small Business Majority. Ed Howard of the Alliance and Sara Collins of The Commonwealth Fund co-moderated.


Full Transcript (MS Word)

Speaker Presentations

Sara Collins (PowerPoint)
Timothy Jost (PowerPoint)
Terry Gardiner (PowerPoint)

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Speaker Biographies (MS Word)

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