Next Generation Health Exchanges

Public health insurance exchanges are online health insurance marketplaces set up by the U.S. Federal Government and certain states, where individuals and small businesses can shop for, compare, and purchase private health insurance. Currently, these public exchanges are the only place where consumers and small businesses can access tax subsidies and credits to buy coverage.

Health insurance is a highly complex product. Effective education, outreach, and consumer tools are needed to help consumers find and enroll in the best products to meet their needs. For example, consumers tend to have difficulty accessing accurate estimates of total out-of-pocket costs and confirming whether their preferred providers and/or prescribed medications are covered across their plan options.

Unfortunately, most of the insurance exchanges have failed to provide adequate tools to aid consumers and have faced numerous technical challenges along the way. As a result, we have seen lower than expected enrollment, which has a negative impact on risk pools and premiums.

CAHC encourages the development of “Next Generation Exchanges,” which would allow the private sector to take on more responsibility for exchange functions that are currently exclusively provided by federal and state governments. This proposal would allow consumers and small businesses to use tax subsidies and credits to purchase state approved insurance products from any site. This has the potential to accelerate access and development of innovative tools to aid consumers, better target and engage consumers, and lower costs for taxpayers.