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What do exchanges do?

__________________________________ Briefing on Health Insurance Exchanges under ACA ______________________________ Jon Kingsdale, Ph.D. Rhode Island Healthcare Reform Commission June 2, 2011. What do exchanges do?. Inform the public & reach out to the uninsured

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What do exchanges do?

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  1. __________________________________ Briefing on Health Insurance Exchanges under ACA______________________________Jon Kingsdale, Ph.D. Rhode Island Healthcare Reform CommissionJune 2, 2011

  2. What do exchanges do? • Inform the public & reach out to the uninsured • Determine eligibility and subsidy flows 3. Enroll subsidized & unsubsidized market segments 4. Specify plan designs & cost-sharing 5. Rate, select, contract & market QHPs

  3. Faces of health reform “If I didn’t have health insurance, I would never have made an appointment with my doctor because of the cost. The cancer would have spread and I would not be alive today to tell you my story.” - Jaclyn Michalos, 27

  4. Faces of health reform Before moving to Mass in 2007, she was told by an insurance agent in her home state: “You’ll never get insurance, so don’t waste your time.” After discovering Commonwealth Choice: “I did the whole thing online and got a very good plan. I was just thrilled!” Abbie von Schlegell, Commonwealth Choice member

  5. Potential policy goals for RIHBE • Near-universal enrollment • Simplify buying/increase transparency • Enhance competition among insurers • Reduce the cost of distributing insurance • Hold insurers accountable to consumers • Transform delivery of medical care • Maintain/support safety net providers • Engage consumers in trade-offs & wellness

  6. Lessons from MA’s Experience • How did the Connector effect health plan entry, mergers, competition? • What did the Connector do on containing health care costs? • Did the Connector stimulate delivery system reform?

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