Insurance Exchanges

This brief explores how states may be able to use CHIP to help meet some of the child-specific requirements for exchanges in the ACA. Options for doing so include: using CHIP as model for pediatric benefits and providers in the exchange; using CHIP funds to provide premium assistance for eligible children to buy exchange coverage that would allow families to be insured by one coverage program; and using CHIP to wrap around Essential Health Benefit benchmark benefits to ensure children’s unique needs are met.

This report examines the ACA’s 3:1 age rating band, which stipulates that premiums for adults age 64 can be no more than three times higher than the premiums for adults age 21 for the same coverage, and its impact on health insurance premiums. 

This analysis was prepared to assist in planning for the design, implementation, and operation of a successful SHOP Exchange in New York State. It provides an overview of state and federal laws and regulations relating to the design and implementation of the SHOP; identifies potential options and decision points related to the design of the SHOP; summarizes other states' approaches to developing a SHOP; and provides a SHOP concept of operations, including the identification of key SHOP business processes.

With the passing of the partnership deadline on February 15, 26 states have defaulted to the Federally Facilitated Exchange (FFE), and it will now be the responsibility of the Department of Health and Human Services to get the exchanges up and running in these states. This brief provides an overview of the requirements necessary to establishing a FFE and the challenges that the federal government may face in implementing them in 26 different states. 

The Center on Budget and Policy Priorities has updated its guide “State Policy Decisions in State-Based Exchange Implementation”. This guide is a compilation of the policy decisions states will need to make when building a state-based exchange. This guide identifies areas where states have flexibility in the design of their exchanges and helps advocates, policymakers, and other stakeholders look for ways to get involved in this process.