System Messages

state of implementation

Primary tabs

    Washington

    Milestone: Decide whether to keep separate or merge the individual and small group market risk pools

    States can merge or keep separate individual and small group markets. Merging markets can stabilize premiums and reduce rates for individuals, but may increase small group premiums and affect available strategies to avoid risk selection.


    read more

    States can merge or keep separate individual and small group markets. Merging markets can stabilize premiums and reduce rates for individuals, but may increase small group premiums and affect available strategies to avoid risk selection.

    *Milestone details:

    *Full name: Decide whether to keep separate or merge the individual and small group market risk pools.

    *Relevance to the ACA:

    The ACA gives states the option to either merge or keep separate their individual and small group markets, excluding grandfathered plans. Relevant sections include:

    §1312 - Requires insurers to consider all enrollees in the individual market to be part of one risk pool and all enrollees in the small group market to be in one risk pool, regardless of whether they purchased coverage through the Exchange, unless they are enrolled through a grandfathered plan. A state also has the option to require that individual and small group markets be merged.

    less

    comment, ask a question or post a document

    Login or Register to participate in this discussion or post a document

    Rachel Dolan
    District of Columbia
    This issue brief explores the potential goals of an Exchange in WA, including: reducing the number of uninsured and increasing access to care; ensuring greater accountability and transparency; increasing the portability and continuity of coverage;... read more

    This issue brief explores the potential goals of an Exchange in WA, including: reducing the number of uninsured and increasing access to care; ensuring greater accountability and transparency; increasing the portability and continuity of coverage; simplifying health insurance purchasing; increasing competition in the health insurance marketplace; and driving quality improvement and cost containment. Access the brief here: http://www.statereforum.org/sites/default/files/waexchange_goalvalue_iss...

    Rachel Dolan
    District of Columbia
    This bill establishes a Health Benefits Exchange and creates a health benefit development board. The board is charged with creating a development plan that contains recommendations on goals, functions, governance, regional exchanges, financial... read more

    This bill establishes a Health Benefits Exchange and creates a health benefit development board. The board is charged with creating a development plan that contains recommendations on goals, functions, governance, regional exchanges, financial sustainability, market impacts, and plan certification. Access the bill here: http://www.statereforum.org/sites/default/files/wa_sb5445.pdf

    Rachel Dolan
    District of Columbia
    This bill, introduced by the House of Representatives, would establish a state health benefits Exchange and requires its governance structure to be in place by July 2012. The bill leaves many future decisions up to the legislature and governor, but does... read more

    This bill, introduced by the House of Representatives, would establish a state health benefits Exchange and requires its governance structure to be in place by July 2012. The bill leaves many future decisions up to the legislature and governor, but does specify that the Exchange shall be governed by a public-private partnership. The Washington State Health Care Authority, in consultation with the legislature’s Joint Select Committee on Health Reform Implementation, would develop a set of options for a variety of implementation decisions. Access the bill here: http://www.statereforum.org/sites/default/files/1740-s.pdf