Health Insurance Exchange Resources

The Robert Wood Johnson Foundation funded the National Academy of Social Insurance to develop a tool kit for states contemplating setting up a health insurance exchange under the Affordable Care Act. Here are summary slides of the project guidance.

The  draft legislation in the toolkit is laid out in a way that makes clear how and where the NASI/RWJF project recommends expansions or modifications of the draft legislation put out by the National Association of Insurance Commissioners. For example, the NASI/RWJF materials suggest further stipulations about transparency of financial arrangements, and provide extra detail for how to deal with Medicaid/CHIP eligibility in exchanges.

In my state of North Carolina, developing the governance structure for an exchange has been a key sticking point; especially the makeup of any board membership. The NASI/RWJF materials outlines three potential governance structures:

  • Cabinet-level executive branch agency
  • Independent executive branch agency
  • Private, Non-Profit board

Each state has particular issues of focus, struggle and controversy, including whether to seek to block the law, move to implement it, or both at the same time (like in North Carolina). The NASI/RWJF tool kit provides great information about many topics for all states.

update: added Insurance to the title of the post.

About Don Taylor
Professor of Public Policy (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute), and Chair of the Academic Council at Duke University . I am one of the founding faculty of the Margolis Center for Health Policy. My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

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