Health Insurance Exchanges: Key Issues for State Implementation

As states across the country begin to contend with decisions regarding the implementation of health insurance exchanges, they are sure to encounter questions like this:

  • Should our state establish our own exchange, or use the federal fall-back option?
  • What is the right way to govern and administer the exchange?
  • What will the role of health care brokers and navigators be in the exchange?

The State Coverage Initiatives (SCI), a national program of the Robert Wood Johnson Foundation, and Robert Carey, formerly of the Massachusetts Connector, collaborated to answer these and other questions and provide guidance to state policy makers working on implementation. This report delves into how states can most effectively address issues about eligibility, enrollment, benefit levels, plan selections, and premium collection and tracking.

This publication adds to SCI’s expanding collection of resources on health insurance changes. In addition, SCI provides customized technical assistance to state policy makers.