Many State Health Insurance Marketplaces will Exceed Requirements

This October brought a monumental start for the country. With its first day, the health care marketplaces opened, and the largest, most complex aspect of the Affordable Care Act began.

While there are problems to fix, the state-run health insurance marketplaces are poised for success, as they are expected to exceed minimum requirements by 2014.

According to a Commonwealth Fund report, the state-run exchanges will surpass federal quality-reporting standards, offer small-business employees a choice of health plan and promote a seamless “one-stop shop” for consumers to begin coverage.

The report found that several states are achieving this by using innovative tactics to improve consumers’ experience beyond the law’s requirements:

  • Reporting quality: Nine states plan to display data on quality in their marketplaces. This is two years before the act requires such data.
  • Increasing options: Small-business employees in state-run marketplaces will have more choices. Nearly all of these marketplaces will provide firms with the more than one plan, starting in 2014
  • Promoting insurer participation: Eight states and the District of Columbia have adopted formal rules to require or incentivize insurers to participate in the marketplaces.
  • Balancing members: Many states have taken steps beyond act requirements to encourage a balance of health and sicker people in the marketplace so that participating plans do not end up insuring mostly unhealthy people.
  • Limiting choice for ease: Insurance carriers may sell at five different tiers of coverage. But many states are limiting the number of plans an insurer can sell at each tier in order to make the choices more manageable.
  • Streamlining eligibility: Fourteen states and the District of Columbia used federal funds to adopt a one-stop shop computer system that will determine coverage potential enrollees are eligible for.
  • Improving assistance: In addition to allowing agents and brokers to sell coverage, the state exchanges are also expected to educate consumers and help them sign up for health coverage.

For more information on the state-run health exchanges, see the press release this information was taken from or the report it concerned. Also please visit the ClaimLinx Exchange as well as the interactive guide to health reform for additional resources and information.

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