Health Insurance Marketplaces: Different Strokes for Different States

August 9, 2013

The Patient Protection and Affordable Care Act (ACA) sets October 1, 2013 as opening day for enrollment in health insurance plans through marketplaces, or exchanges. The law allowed states to choose between running their own exchanges or having the Department of Health and Human Services (HHS) run a federally facilitated exchange.

HHS also created variations that allow states to take charge of some, but not all, exchange functions, in partnership with the federal government. The law also gave states some design flexibility. For example, states may decide how many plans participate on the exchange, how the exchange is governed and requirements for participation. This briefing will look at some of the choices states have made and the status of the exchanges in the three categories.

For states that are running their own exchanges, what design choices are they making? What design choices will prevail in the federally facilitated exchanges? Will all marketplaces be ready to open enrollment on October 1, 2013? How are states and the federal government engaging in outreach to inform consumers about the exchanges and their eligibility to enroll through one?

A distinguished panel of experts addressed these and related questions.

Karen Ignagni, president and CEO of America’s Health Insurance Plans (AHIP), described how the industry has been working with states, what types of plans they expect to offer and potential premium changes.

Sarah Dash, research faculty at the Health Policy Institute, Georgetown University, discussed results from a new study of state-based health insurance exchanges.
Chiquita Brooks-LaSure, deputy director on policy, Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services, spoke about the center’s preparations to operate federally facilitated exchanges.
Rebecca Pearce, executive director of Maryland’s Health Benefit Exchange, talked about Maryland’s preparations to open its state-based exchange.
Joseph Thompson, surgeon general for the state of Arkansas, and director of the Arkansas Center for Health Improvement, provided the perspective of a state going forward with a partnership exchange.
Ed Howard of the Alliance and Sara Collins of Commonwealth co-moderated the discussion.

Contact: Deanna Okrent 202/789-2300

The event was sponsored by the nonpartisan Alliance for Health Reform and The Commonwealth Fund.


Speaker Presentations

Sara Collins Presentation (Adobe Acrobat PDF)
Sarah Dash Presentation (Adobe Acrobat PDF)
Rebecca Pearce Presentation (Adobe Acrobat PDF)
Joseph Thompson Presentation (Adobe Acrobat PDF)
Karen Ignagni Presentation (Adobe Acrobat PDF)

Event Details

Agenda (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)

Event Resources