Exchanges

Health plans have long supported exchanges as one option among many to provide consumers with access to innovative plan choices and clear and consistent information that can help aid decisions about all coverage options.  Under the new law, individuals and small businesses will have access to new exchanges starting in 2014.  The ACA outlines a set of federal requirements for state-based exchanges, and if a state chooses not to set up an exchange, consumers in the state will have access to a new federal exchange. 

In order to enhance competition and provide greater choice for consumers, the following principles should guide the development of these exchanges:

• Exchanges should be established at the state level because states have the experience, infrastructure and local market knowledge to ensure exchanges are able to meet the unique needs of the populations in each state. 
• When establishing exchanges, states should avoid imposing unnecessary, costly and duplicative regulations that will result in higher costs and reduced choice for consumers.  For example, the function of premium rate review should be handled by existing state regulatory agencies and not duplicated through the exchanges.
• Exchanges should not be the only option for obtaining coverage in the market, but function as another channel to help individuals, families and employers find the coverage that is right for them. 
• To maximize consumer choice, states should ensure that exchanges establish clear, consistent, and objective criteria for health plan participation based on the requirements in the ACA and existing state legal and regulatory standards.
• To enhance private market competition and consumer choice, health insurance exchanges should permit all qualified health plans to participate in these new marketplaces.