TAILIEUCHUNG - Establishing Health Insurance Exchanges: An Overview of State Efforts

“One size fits all” is not appropriate for poverty reduction, because con- ditions are different and because governments’ abilities are different. FOSIS in Chile, a fund that was not supported in any major way by the IDB, is a central part of the government’s machinery for poverty allevia- tion and is extremely flexible. The fund concentrates on productive projects, supports substantial microcredit activities, and imparts sub- stantial training to communities. It is also crucial that governments increase their contributions to the resources allocated to social funds if the funds are going to be perma- nent. The funds are a way to direct more government goods and ser- vices to the. | FOCUS THE HENRY J. on Health Reform KAISER FAMILY FOUNDATION AUGUST 2012 Establishing Health Insurance Exchanges An Overview of State Efforts Following the Supreme Court s decision to uphold the Affordable Care Act ACA and preserve the individual mandate state-based health insurance exchanges remain a key component of the ACA. Exchanges will be the mechanism through which millions of low and moderate-income individuals receive premium and cost-sharing subsidies to make private health coverage more affordable and where employees of small businesses will be able to purchase coverage. States can elect to build a fully state-based exchange enter into a state-federal partnership exchange or default into a federally-facilitated exchange. Exchanges are required to be fully operational in every state by January 1 2014 and their readiness will be evaluated by the federal Department of Health and Human Services HHS one year prior to opening. States planning to operate a state-based exchange or a state-federal partnership exchange are required to submit an exchange blueprint consisting of a declaration letter signed by the Governor and an application to HHS by November 16 2012. Given these fast approaching deadlines and that most states legislative sessions have come to a close states face serious challenges to making the necessary policy and implementation decisions. State Action Toward Creating Health Insurance Exchanges PA Estali ed state Exchange 15 DC As of July 30 2012 WI MI L_ IN VA NC MA RI CT NJ DE MD DC No Significant Activity 9 Planning for Partnership Exchange 3 Decision Not to Create State Exchange 7 Studying Options 16 To date 15 states plus the District of Columbia have established state-based exchanges. Of those three have done so via executive order Rhode Island New York and Kentucky. The majority of states with established exchanges have appointed Boards hired staff and solicited subcontractors to begin planning and building exchange infrastructure. These .

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