Various proposals to expand coverage to uninsured Americans and reform the health insurance market include the establishment of a health insurance exchange. The most widely discussed example of such an exchange is in Massachusetts, and it arrived recently with Massachusetts’ 2007 health reform efforts. Many are looking to the Connector, as the Massachusetts program is known, to inform their discussions of a national insurance exchange. But is that the only model?
What is actually meant by a health insurance exchange and how might it work? Would it look more like a “farmer’s market”, or would it be more heavily regulated? Who would be allowed to seek coverage through the exchange, and what might be the rules governing the conduct of plans offering the coverage? What’s in it for the consumer? How would vulnerable populations be protected? Are other reforms needed to make it work? Is there potential for cost containment with an insurance exchange model? Who stands to benefit?