Health insurance exchanges, explained

The health insurance exchange is one of the most important concepts in federal health reform, and Julie Appleby of Kaiser Health News offers a helpful primer on the exchanges, with details on how they are expected to work, who will be allowed to buy coverage through them, and what flexibility states have in designing their own exchanges.

Planning for Connecticut’s exchange is underway; Gov. Dannel P. Malloy recently signed a law establishing the state’s exchange as a quasipublic agency.

Appleby notes that states are taking different approaches to the composition of the boards that will govern their exchanges. Some are contemplating allowing or requiring some board members to be affiliated with the health care and insurance industries, while others are looking to prohibit it. One of the more controversial parts of Connecticut’s exchange law is that it prohibits board members from being employed by or otherwise affiliated with insurers, insurance producers or brokers, health care providers or health care facilities, or their trade groups. Board members will have to have expertise in specific areas, including small employer health insurance coverage, health care finance, health care delivery systems, self-employed individuals’ health care access issues, and barriers to individual health care coverage.