Mitigating Risk in a State Health Insurance Exchange

Under the Affordable Care Act, all states must either develop or participate in a health insurance exchange which must give consumers complete and easy-to-understand information about health insurance options. Since this requirement was modeled after Massachusetts’ health reform law, many are turning to Massachusetts officials for learnings from the past five years.

The series’ fourth installment examines three key strategies intended to ease adverse selection and stabilize health insurance premiums when insurance market reforms are implemented in 2014. This toolkit guide describes the process used by the Connector to develop its risk mitigation program for Commonwealth Care, and highlights key lessons learned in implementing Commonwealth Care and their relevance to other states implementing the ACA.

This toolkit series, released by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation, provides examples, templates, and lessons from Massachusetts. Each toolkit includes a written narrative and a variety of source documents, including examples of organizational structures, job descriptions, requests for proposals, and other documents that can help states implement reform.