Health Insurance Exchanges

As you know, under health reform, each State is supposed to create a new marketplace where consumers can shop for insurance. These marketplaces are called Exchanges under the law. This may sound simple enough -- design a website, make it interactive so people can pull up the policies that best suit them, and make that information available to consumers. Not so fast.

There are so many questions involved in how a State wants to design its Exchange. For example, is it good for the Exchanges to list all available plans, or should they weed some out, perhaps negotiate better premiums even, and show you your best options? Should the individual market and small market be combined or separate? What are the best ways to make sure that only sick people, who can't get insurance outside the Exchange due to pre-existing conditions, don't all flock to the Exchange, driving up prices inside the Exchange, with the healthy people paying less outside the Exchange (called "adverse selection")?

The Connecticut Office of Policy and Management asked some of the consumer advocates in the State for our thoughts, and we gathered them here. As you can see, they are detailed and a bit complicated, but if you're interested in seeing our approach and recommendations, there you go. There will be a meeting on May 3 to discuss these ideas further. So if you have some thoughts, please let me know.

Unless you're inclined to curse out health reform or President Obama, in which case I'd love it if you kept it to yourself. Jennifer

P.S. -- NOTE that OPM will be conducting a series of public forums to hear what you think about how the Exchange should be designed. They are as follows:

• April 25 at 6:30 p.m. in Danbury City Hall, 155 Deer Hill Ave.;
• April 27 at 6:30 in the New London Public Library, 63 Huntington St.;
• May 5 at 7 p.m. in New Haven City Hall, 165 Church St.;
• May 9 at 6 p.m. in Downtown Hartford Public Library, 500 Main St.;
• May 17 at 6:30 p.m. at Windham Middle School, 123 Quarry St.