For Immediate Release | December 20, 2011


Jill Braunstein at (202) 452-8097

WASHINGTON, DC – States and stakeholders get a first look at different models for health insurance Exchanges authorized in the Affordable Care Act (ACA) in a new report released today by the National Academy of Social Insurance (NASI). The report explores the continuum of Exchange options, from entirely state-operated to entirely federally-operated, and examines the implications for states in selecting various models in terms of Exchange functions and operations.

“In selecting among a range of Exchange options, states face complex challenges in balancing the desire for autonomy with the opportunity to rely on federal solutions for new responsibilities required of all Exchanges,” said Deborah Bachrach, co-author with Patricia Boozang, both of Manatt Health Solutions. “This report suggests how the core functions of the Exchange might be effectuated in State-based, Federally-facilitated and Partnership Exchange models and the legal, operational and fiscal implications of each.” The core functions addressed are eligibility, enrollment, plan management, consumer assistance and financial management.

Federally-Facilitated Exchanges and the Continuum of State Options, part of a NASI project funded by the Robert Wood Johnson Foundation (RWJF) and the RWJF State Health Reform Assistance Network, is one of the first examinations of the different Exchange models since the Department of Health and Human Services issued draft regulations in the summer of 2011 and guidance in November 2011. Related products include a toolkit offering legislative language for policymakers implementing Exchanges and issue briefs on Exchange governance and active purchasing.

Please join NASI and RWJF for a webinar featuring Bachrach and Boozang, as well as the authors of a forthcoming paper by Sara Rosenbaum and Patricia Riley on harmonizing the Exchange and state Medicaid programs, January 10th, 2012 from 2:00 to 3:30 EST. Click here for details and to RSVP.

Contact Information 
For more information about Federally-Facilitated Exchanges and the Continuum of State Options, contact Deborah Bachrach at or Patricia Boozang at For information about NASI’s Health Insurance Exchange project, please contact Lee Goldberg at or visit

The National Academy of Social Insurance (NASI) is a nonprofit, nonpartisan organization made up of the nation’s leading experts on social insurance. Its mission is to advance solutions to challenges facing the nation by increasing public understanding of how social insurance contributes to economic security.

See related news: Medicare and Health Policy

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