When California first envisioned its reform-inspired health insurance exchange, state officials had three basic options in designing the exchange:
- As a market definer and organizer, in which the exchange becomes the market;
- As a purchaser, in which the exchange selectively contracts with insurers; or
- As a clearinghouse in which the exchange acts as a platform for all plans offered by all issuers.
California chose the middle path, creating an exchange that will act as a discerning patron of plans.
At its meeting this month, the exchange board will consider some of the details about how to define that discernment.
A new issue brief from the Pacific Business Group on Health urges exchange board members to play an active role in promoting the quality and affordability of health care in California. Rather than acting as a passive online clearinghouse with a variety of plan options, PBGH urges the exchange to establish quality standards for plans and useful tools to help consumers pick the plan that is right for them.
In essence, PBGH is urging the exchange, as it navigates the middle road, to lean more toward the first option as market definer and organizer.
We asked stakeholders how the exchange should steer down this path.
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