Abstract

California, Colorado, and Maryland were among the first states to enact legislation establishing health insurance exchanges called for in the Affordable Care Act. This brief outlines differences that stand out in the states' initial approaches: the numbers and types of people initially appointed to the boards governing the exchanges; the role of the board relative to the state legislature; how the exchanges interact with existing insurance markets; and the involvement of stakeholders in each state. The decisions made by these states provide information that will be useful for other states implementing their exchanges. Going forward, these states will face a more challenging set of decisions, including how to finance the exchanges, how to make risk-adjusted payments to insurers for people likely to have high medical expenses, and how to avoid gaps in coverage and care for people who may have changes in income.

Authors

Hall MA, Swartz K

Institution

Wake Forest University School of Law, USA. mhall@wfu.edu

Source

Issue brief (Commonwealth Fund) 18: 2012 Jul pg 1-14

MeSH

Advisory Committees
California
Colorado
Diffusion of Innovation
Health Benefit Plans, Employee
Health Care Reform
Health Care Sector
Humans
Insurance, Health
Maryland
Patient Protection and Affordable Care Act
State Government
United States

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22808557