Milestone: Establish governance of the Exchange
Governance choices will shape Exchange operations, accountability, and the impact of the Exchange on health insurance markets. States will want to align governance decisions with their overall Exchange goals and priorities.
*Milestone details:
*Full name: Establish governance of the Exchange
*Relevance to the ACA:
The ACA requires that the Exchange be a nonprofit entity or governmental agency established by a state, but gives states great flexibility within these broad parameters. Sections relevant to Exchange governance include:
§1311 - Creates grants for states to plan and launch Exchanges. Requires Exchanges to be nonprofit entities or governmental agencies.
§1321 - Requires the Secretary to give guidance related to the creation of Exchanges. This section also gives the Secretary the power to establish and operate an Exchange in a state that defers or whose Exchange does not meet statutory requirements.
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New York
A third health insurance exchange reproduced by the United Hospital Fund focuses on two discretionary decisions New York faces under the Affordable Care Act: first, merging the health benefit exchanges for individuals and small businesses, and second, merging the individual and Small Group markets. Through analysis of different scenarios, the report presents estimates of the premium change that would result from setting rates for these populations based on the combined experience of individuals and groups.
http://www.uhfnyc.org/publications/880772
New York
A second health insurance exchange report produced by the United Hospital Fund examines the organizational improvements needed to improve and integrate current Medicaid processes for eligibility and enrollment, information technology, and beneficiary communications with the health insurance exchange now being designed in New York as part of federal health care reform. According to the report, successful integration will require careful attention to five key areas: eligibility and enrollment, renewals and transitions, information systems, consumer communications, and challenges associated with aligning the plans, networks, and benefits offered. The full report is available at http://www.uhfnyc.org/publications/880749.
New York
This report, produced by the United Hospital Fund, examines key structural decisions New York State must make as it sets up a health insurance exchange to meet federal Affordable Care Act deadlines. It is based on a thorough review of the federal reform law, New York laws and regulations, and activities in Massachusetts and other states. Providing an analytical framework for state policymakers, it lays out the type and scope of possible exchanges and presents a detailed assessment of governance issues: http://www.uhfnyc.org/publications/880723.
District of Columbia
This report provides an update on NY's projects related to the Exchange planning grant. Access the report here: http://www.statereforum.org/sites/default/files/ny_q1_exchange_planning_...
District of Columbia
This report, produced by the United Hospital Fund, outlines the requirements for setting up an exchange under the ACA and the key decisions that New York state policymakers will need to consider. The report weaves in information about the state’s current fiscal and regulatory environment to provide further context for policymakers. Access the report here: http://www.statereforum.org/sites/default/files/ny_hix_jan2011.pdf