Small-Group Session

Issues in Health Insurance Reform: Health Insurance Exchanges
March 6, 2009


Sally Coberly, PhD


This small-group meeting provided an opportunity for in-depth discussion of insurance exchanges for purchasing individual and small-group insurance. The types of functions an exchange might perform were laid out, followed by a detailed description of the health insurance programs, CommCare and CommChoice, administered by the Massachusetts Commonwealth Connector, and the market context in which they operate. The experience of the Health Insurance Plan of California, a purchasing pool for small employers that eventually went out of business, was also highlighted.


John M. Bertko, FSA, Adjunct Staff, The RAND Corporation; Jon Kingsdale, PhD, Executive Director, Commonwealth Health Insurance Connector Authority; Leslie Cummings, Executive Director, California Managed Risk Medical Insurance Board

Slides from the presentations by Mr. Bertko and Dr. Kingsdale are available for download. A handout from the meeting (letter from PacAdvantage to the California Managed Risk Medical Insurance Board) and the speakers' biographies are also available.

Related Materials

Other recent meetings in the Forum's series on health insurance reform include sessions on underwriting, rating, and regulation in the individual market (December 3, 2008); rating rules in the individual market, part II (February 19, 2009); risk adjustment and rating in the small-group market (March 20, 2009); actuarial equivalence (April 7, 2009); health insurance exchanges, part II (April 15, 2009); and federal/state regulatory roles, subsidy administration (May 8, 2009).

Other resources include "Overview of Purchasing Pool Policy Options" (RAND Compare); "Massachusetts Health Reform: Solving the Long-Run Cost Problem," by John Holahan and Linda J. Blumberg (Urban Institute, January 15, 2009); and "Health Insurance Connectors and Exchanges: A Primer for State Officials," by Amy Lischko (Academy Health State Coverage Initiatives, September 2007).

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