State, Federal and Private Exchanges: What is Available and How Do They Work?

State, Federal and Private Exchanges: What is Available and How Do They Work?

Don’t be left behind - discover the different types of health exchanges and how they work. The concept of state-based marketplaces—or “exchanges”—is central to the Affordable Care Act’s (ACA) approach to health care reform. And while the ACA has had more than its share of controversy, there is little dispute over its high-level aims: reduce health care costs, increase the quality of medical outcomes, and expand coverage. Irrespective of what the future holds for the ACA, it’s a safe bet the exchange model will survive. In theory, exchanges leverage technology to offer near perfect access to, and information about, available medical insurance coverage options. In practice, there is still work to do. This topic will examine the origins, regulation, and implementation of the exchanges under the ACA. This topic will also provide you with a comprehensive understanding of the exchange model and its place in the ACA’s regulatory scheme, and we will handicap both the design and the implementation of the exchanges to date, with a particular focus on the different state “operating environments” in which the exchange model is being implemented. At its core, a private exchange is a private business – typically operated by insurance brokers, benefit consultants, or insurers – that offers health insurance products to consumers through an electronic platform. It is important to understand that private exchanges were in existence prior to the enactment of the ACA, although private exchanges have increased in notoriety on account of the new law. While enrollment in private exchanges has not taken off like many consultants projected back in 2014, it is expected that private exchange enrollment in the group market will continue to steadily increase over the next 5 to 10 years. This topic will examine the features that make a private exchange unique and attractive to employers and employees. And, we will discuss the staying power of private exchanges as changes to the ACA and the tax treatment of employer-sponsored insurance are considered by Congress and the next president.

Learning Objectives