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Designing an Exchange: A Toolkit for State Policymakers

By: Study Panel on Health Insurance Exchanges
Published: January 2011
This legislative toolkit will assist with the design of health insurance Exchanges, a key element of the Patient Protection and Affordable Care Act (ACA).
 
It was developed by a panel of experts from a variety of disciplines and perspectives and builds on the model law released by the National Association of Insurance Commissioners (NAIC) in late 2010.
 
The NASI legislative language offers options in a number of key areas, including Exchange governance, establishment of a Small Business Health Options Program (SHOP) for small employers, eligibility determination and enrollment, certification of qualified health plans, and coordination with Medicaid and the Children’s Health Insurance Program. It also includes a section-by-section guide that documents NASI’s additions to the NAIC language and a narrative discussion of the concerns that motivated the alternatives presented.
 
The toolkit was produced as part of a NASI project funded by the Robert Wood Johnson Foundation to provide technical assistance to states developing health insurance Exchanges.