The National Academy of Social Insurance has issued a legislative toolkit intended to provide options for policymakers in implementing health insurance exchanges — a key element of the Affordable Care Act.
NAIC officials said the toolkit was developed by a panel of experts from a variety of disciplines and perspectives and builds on a model law they released in late 2010.
[Read more about NAIC's model framework for health exchanges.]
"This year, state lawmakers throughout the country will be taking major steps toward making the promise of affordable and accessible health insurance coverage real for tens of millions of people," said Deborah Chollet, a Senior Fellow at Mathematica Policy Research and co-chairwoman of the panel.
Health insurance exchanges will offer individuals and small businesses high-quality health insurance products known as qualified health plans, said Sara Rosenbaum, professor and chairwoman of the Department of Health Policy at George Washington University and a co-chairwoman of the panel. Exchanges are intended to promote competition among health plans on price and quality and help consumers and employers make the best coverage choices by providing information, support and assistance. In addition, she said, low-income individuals can qualify for advance premium assistance tax credits and can benefit from lower out-of-pocket costs by enrolling through an exchange.
The toolkit is the first product of an NASI project funded by the Robert Wood Johnson Foundation to provide technical assistance to states developing health insurance exchanges, the panel said. The NASI legislative language offers options in a number of key areas, including exchange governance, establishment of a small business health options program (SHOP) for small employers, eligibility determination and enrollment, certification of qualified health plans and coordination with Medicaid and the Children's Health Insurance Program. It includes a section-by-section guide that documents the NASI's additions to the NAIC language and a discussion of the concerns that led to the alternatives, the group said.
[Is the creation of health insurance exchanges a race with no finish line?]
In addition to the toolkit, the NASI released an issue brief focused solely on exchange governance. "Governance Issues for Health Insurance Exchanges" is the first in a planned series of issue briefs exploring major design and implementation issues for exchanges.
"Many issues can be deferred or delegated. Governance of the exchange is the one issue that all states will need to address soon in order to meet the 2013 deadline for showing capacity to operate a successful exchange," said Paul Van de Water, co-author of the issue brief, a study panel member and senior fellow at the Center for Budget and Policy Priorities.
Download the toolkit here.