The Robert Wood Johnson Foundation funded the National Academy of Social Insurance to develop a tool kit for states contemplating setting up a health insurance exchange under the Affordable Care Act. Here are summary slides of the project guidance.
The draft legislation in the toolkit is laid out in a way that makes clear how and where the NASI/RWJF project recommends expansions or modifications of the draft legislation put out by the National Association of Insurance Commissioners. For example, the NASI/RWJF materials suggest further stipulations about transparency of financial arrangements, and provide extra detail for how to deal with Medicaid/CHIP eligibility in exchanges.
In my state of North Carolina, developing the governance structure for an exchange has been a key sticking point; especially the makeup of any board membership. The NASI/RWJF materials outlines three potential governance structures:
- Cabinet-level executive branch agency
- Independent executive branch agency
- Private, Non-Profit board
Each state has particular issues of focus, struggle and controversy, including whether to seek to block the law, move to implement it, or both at the same time (like in North Carolina). The NASI/RWJF tool kit provides great information about many topics for all states.
update: added Insurance to the title of the post.