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Briefing on Health Insurance Exchanges under ACA______________________________

Jon Kingsdale, Ph.D.

Rhode Island Healthcare Reform Commission

June 2, 2011

What do exchanges do?

1. Inform the public & reach out to the uninsured

2. Determine eligibility and subsidy flows

3. Enroll subsidized & unsubsidized market segments

4. Specify plan designs & cost-sharing

5. Rate, select, contract & market QHPs

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Faces of health reform

“If I didn’t have health insurance, I would never have made an appointment with my doctor because of the cost. The cancer would have spread and I would not be alive today to tell you my story.” - Jaclyn Michalos, 27

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Faces of health reform

Before moving to Mass in 2007, she was told by an insurance agent in her home state: “You’ll never get insurance, so don’t waste your time.”

After discovering Commonwealth Choice: “I did the whole thing online and got a very good plan. I was just thrilled!” Abbie von Schlegell , Commonwealth Choice member

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Potential policy goals for RIHBE

•Near-universal enrollment•Simplify buying/increase transparency•Enhance competition among insurers•Reduce the cost of distributing insurance•Hold insurers accountable to consumers•Transform delivery of medical care•Maintain/support safety net providers•Engage consumers in trade-offs & wellness

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Lessons from MA’s Experience

1. How did the Connector effect health plan entry, mergers, competition?

2. What did the Connector do on containing health care costs?

3. Did the Connector stimulate delivery system reform?

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