Designing an Exchange: A Toolkit for State Policymakers

Source: Study Panel on Health Insurance Exchanges, National Academy of Social Insurance, January 2011

From the press release:
A legislative toolkit that will assist states with the design of health insurance Exchanges — a key element of the Patient Protection and Affordable Care Act (ACA) — was released today by the National Academy of Social Insurance (NASI).

Developed by a panel of experts from a variety of disciplines and perspectives, the toolkit builds on the model law released by the National Association of Insurance Commissioners (NAIC) in late 2010….

…Health insurance Exchanges will offer individuals and small businesses high quality health insurance products known as qualified health plans. Exchanges are intended to promote competition among health plans on price and quality, and to help consumers and employers make the best coverage choices by providing information, support, and assistance. In addition, low-income individuals can qualify for advance premium assistance tax credits and can benefit from lower out of pocket costs by enrolling through an Exchange.

The toolkit (PDF) is the first product of a NASI project funded by the Robert Wood Johnson Foundation to provide technical assistance to states developing health insurance Exchanges. The NASI legislative language offers options in a number of key areas, including Exchange governance, establishment of a Small Business Health Options Program (SHOP) for small employers, eligibility determination and enrollment, certification of qualified health plans, and coordination with Medicaid and the Children’s Health Insurance Program. It also includes a section-by-section guide that documents NASI’s additions to the NAIC language and a narrative discussion of the concerns that motivated the alternatives presented….
See also:
Governance Issues for Health Insurance Exchanges

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