The Massachusetts and Utah Health Insurance Exchanges

One of the most significant reforms contained within the Patient Protection and Affordable Care Act (ACA) is the requirement that states create—or have the federal government create—health insurance exchanges. Designed to help individuals and small businesses shop for and purchase health insurance, access premium and cost-sharing subsidies, and facilitate health plan competition based on price and quality, these exchanges are projected to be the gateway for approximately 29 million people gaining access to health coverage.

For a handful of states, however, exchanges are not new. A new paper funded by the Robert Wood Johnson Foundation examines two existing ones—the Massachusetts Connector and the Utah Health Exchange. Georgetown Health Policy Institute’s Sabrina Corlette, J.D., and her coauthors note that while both have attracted national attention and are often positioned in opposition to one another, the story is more complicated. They examine three primary dimensions of each exchange: the quality and choice of plans, the affordability of coverage and ease of enrollment. The authors conclude that these two example need not serve as “either-or” contrasts, but instead that elements from both may best serve the residents of other states.