Promoting Healthy Competition in Health Insurance Exchanges: Options and Trade-Offs

The Center for Studying Health System Change released a report funded by the National Institute of Health Care Reform focusing on how health insurance exchanges can promote healthy competition among insurers in the exchanges and in turn provide better health outcomes, at a lower total cost. The analysis focuses on the following questions:

• How much latitude should insurers have in determining the cost sharing features of the plans they offer?
• How should the standard population be defined for the purposes of calculating actuarial value?
• Should exchanges regulate relative premiums?
• How should exchanges implement the reduced out-of-pocket limits for families between 250 and 400 percent of the federal poverty level?
• Should differences among plans in the scope of covered benefits be reflected in the calculation of actuarial value?