State Health Insurance Exchanges

With only two state exchanges currently in existence—in Massachusetts and Utah—we have a lot to learn. Every state is required to establish an exchange to serve individuals who receive tax credits or purchase insurance on their own, and a Small Business Health Option Program (SHOP) for employers with fewer than 100 employees by 2014. Without action, states will be mandated to accept a federally-designed one-size fits all exchange.

With modest support for the federal health care overhaul law among the public and opposition in some state executive offices, the Obama Administration will need to give states significant flexibility in implementing the law. The Administration should allow for a wide diversity of designs that help to address each state’s unique demographic and health care challenges.

Pioneer’s contribution to this discussion is a sensible debate based on facts about the Massachusetts Health Care Reform Act. Pioneer has not yet taken a position on the reform act. We seek first to understand and measure its performance empirically. This was the impetus behind our four part Interim Report Card series.