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Issues in Health Reform

How different states are collaborating in setting up the federally sponsored marketplaces

This report from the Urban Institute looks at the roles 3 states, Alabama, Michigan, and Virginia are playing in the implementation process in their states of federally-facilitated marketplaces/Exchanges. The other states, including Kansas, are not detailed but one can assume similar types of variations in style of collaboration.

The paper’s findings include:

  • Two of the three states are actively engaged in their exchange’s development, although some stakeholders noted they need more information from the government to complete the exchange and prepare themselves in a timely manner.
  • State Departments of Insurance view the regulations and their role in the exchanges as a continuation of their work pre-reform.
  • States are at different stages of readiness, Alabama for instance is lagging as a result of political/administrative hurdles the state faced and they have no plans to assist in the exchange’s development.
  • Consumer assistance programs will need to be created to help people navigate the exchange, although clearing political hurdles will be a challenge in the acquisition of federal funds to pay for such programs.

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