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Publications available from the Theobald Legislative Library
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Health Insurance Exchanges |
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Compiled by Nesara Kishor, October 2010 |
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The recent federal health care legislation has made sweeping changes to health care and health insurance. One of the many changes in the coming years will include the mandatory implementation of health insurance exchanges across all states beginning January 1, 2014. This will raise questions and concerns as states begin working on legislation to implement these exchanges. This bibliography will provide resources that may contribute to our understanding of health insurance exchanges. General Overview "Explaining Health Care Reform: Questions About Health Insurance Exchanges" / Kaiser Family Foundation, April 2010. "This summary provides responses to questions about the purpose and function of exchanges and how they relate to the regulation of the insurance market." www.kff.org/healthreform/upload/7908-02.pdf "Explaining Health Reform: Eligibility and Enrollment Processes for Medicaid, CHIP, and Subsidies in the Exchanges" / Kaiser Family Foundation, August 2010. Provides explanations of different provisions in the law. The enrollment system for Medicaid, CHIP, and subsidies in the exchange must be consumer-friendly, coordinated, simplified, and technology enabled. Summarizes the various positions in the law that address these goals. www.kff.org/healthreform/upload/8090.pdf Health Reform: What Legislators Need to Know About Exchanges / National Conference of State Legislatures. June 4, 2010. Webinar. Slides provide legislators with information about the various functions of an exchange, such as the certification of health plans and determining eligibility standards for subsidies, Medicaid, and CHIP. Discusses relevant issues regarding governance, implementation, and opportunities for states. www.ncsl.org/portals/1/documents/health/Exchangeswebinar60210.pdf "Moving Forward on Health Reform" / Health Affairs, June 2010.
(614.23/P94/2010/v.29/no.6)
Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges / National Association of Insurance Commissioners. April 20, 2010. Lists the provisions in the Patient Protection and Affordable Care Act relevant to the health exchanges in the form of a chart, highlighting key features, applicability, and effective dates. www.naic.org/documents/committees_b_Exchanges.pdf Private Health Insurance Provisions in PPACA (P.L. 111-148) / U.S. Congressional Research Service. April 15, 2010. Provides an in-depth analysis and explanation of the health insurance exchanges described in the Patient Protection and Affordable Care Act. Explains the essential health benefits package, qualified health plans, eligibility for individuals and small businesses, as well as premium and cost-sharing subsidies as they relate to the exchange. http://assets.opencrs.com/rpts/11-148_20100415.pdf State Implementation of Federal Health Reform / National Conference of State Legislatures. Updated September 20, 2010. Provides a comprehensive table detailing state actions in implementing reform, including introduced bills and laws. www.ncsl.org/default.aspx?tabid=20231 "Summary of Coverage Provisions in the Patient Protection and Affordable Care Act" / Kaiser Family Foundation, April 28, 2010. (368.6/K12f) Brief overview of American Health Benefit Exchanges. Specifies eligibility and options for structure. Benefits offered must meet specified standards. Premium and cost-sharing subsidies are available to qualified individuals. www.kff.org/healthreform/upload/8023-R.pdf Issues to Consider Critical Employer Issues in the Patient Protection and Affordable Care Act / U.S. Chamber of Commerce. April 26, 2010. Geared toward employers, this report serves "as a handbook for the business community." Brief explanation of the Small Business Health Options Program (SHOP) exchanges. http://library.uschamber.com/sites/default/files/100426_critical_employer_issues_ppaca.pdf The Exchange Equation: Avoiding a Death Spiral with a Balance of Risks / The Commonwealth Fund. December 18, 2009. State-based exchanges in the past have suffered from adverse selection and high premiums. Discusses measures that could prevent such problems, such as a large market pool and incentives to choose "efficient, high quality plans." www.commonwealthfund.org/Content/Newsletters/Washington-Health-Policy-in-Review/2009/Dec/December-21-2009/The-Exchange-Equation-Avoiding-a-Death-Spiral-with-a-Balance-of-Risks.aspx Health Insurance Exchanges in Health Care Reform: Legal and Policy Issues / The Commonwealth Fund. December 31, 2009. Several questions and policy issues must be taken into consideration when designing the exchanges. Exchanges must be designed to discourage adverse selection, encourage balanced risk pools, and reduce administrative costs. www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/Dec/Health-Insurance-Exchanges-in-Health-Care-Reform-Legal-and-Policy-Issues.aspx A State Policymakers' Guide to Federal Health Reform: Part I, Anticipating How Federal Health Reform Will Affect State Roles / National Academy for State Health Policy. November 2009. (368.6/N214b) Identifies broad areas of focus in current state reform efforts, asking "will [federal] reform support or impede progress toward existing state health system improvement goals?" Experience in Other States "Health Insurance Exchanges: Organizing Health Insurance Marketplaces to Promote Health Reform Goals" / Urban Institute, April 2009. Examines the operation of the Massachusetts Connector and the ways in which exchanges could address current issues facing consumers of insurance. www.urban.org/UploadedPDF/411875_health_insurance_marketplaces.pdf Health Insurance Exchanges: See How They Run / Alliance for Health Reform. May 11, 2009. Webcast. A series of panelists present a discussion about the exchanges and reform goals they could accomplish, focusing on experience with the Massachusetts Connector as a model. www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=3134 "Overview of Massachusetts Health Reform: Exchange Design Issues & Lessons Learned" / National Conference of State Legislatures. July 25, 2010. Slides. Slides give a brief overview of the Commonwealth Choice and Commonwealth Care program, including its subsidized and non-subsidized options. Provides statistics on the successes and shortcomings of the exchange. Lessons learned stress the importance of campaigning, communication and collaboration, consolidating legacy problems, and more. www.ncsl.org/portals/1/documents/health/Exchanges_KingsdaleLS10.pdf "The Utah Health Exchange: Ten Lessons Learned from the Utah Experience" / National Conference of State Legislatures, July 26, 2010. Slides. Provides guidelines for implementing exchanges based on experience with the Utah Health Exchange. Documents the timeline of events involved in the Utah exchange, demonstrates the functions on its Web site, and compares the Utah model with the Massachusetts Connector. www.ncsl.org/portals/1/documents/health/Exchanges_ClarkLS10.pdf Criticisms "Health-Care Reform: Is the Landmark New Plan a Good Idea?" / Congressional Quarterly, Inc., CQ Researcher, June 11, 2010, v.20, no.22. (368.6/C763c) Examines questions and issues regarding the health reform law, describing insurance exchanges as a "pro competitive" element in the law "to encourage private insurers to emphasize cost and quality control." Criticizes that coverage through an exchange would be "inadequate" for consumers. "Prescription for a Health Insurance Compromise: Forget the Public Option and Co-Ops, Rewire the Exchange" / Committee for Economic Development. September 24, 2009. Criticizes that exchanges would "fail to pressure private insurers to hold down premiums." Advocates for Congress to rewrite the law so that exchanges could "attract a pool of participants that are average in risk, large in size, and driven by proper incentives." Points to the Dane County (Wisconsin) Exchange model as one that has been able to control premiums. www.ced.org/commentary/65-commentary/378-prescription-for-a-health-insurance-compromise-forget-the-public-option-and-co-ops-rewire-the-exchange Related Web Sites GPO Access: www.gpoaccess.gov/fr "The Federal Register is the official daily publication for rules, proposed rules, and notices of Federal agencies and organizations." Healthcare.gov: www.healthcare.gov The official government Web site that provides information to consumers on the Patient Protection and Affordable Care Act. Massachusetts Health Connector: www.mahealthconnector.org/portal/site/connector Official Web site for the Massachusetts Health Exchange. National Association of Insurance Commissioners: www.naic.org Provides information on the health reform with an added focus on the role of the NAIC in creating many of the standards and methodologies required in the law. National Conference of State Legislatures: www.ncsl.org Provides updated information on state actions. Go to Health Reform Implementation, or search for "insurance exchanges."
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