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CHIR Report from New Georgetown: In Trump Era, states are revisiting the benefits and risks of having their own health care market HEALTH INSURANCE

By Sabrina Corlette, Kevin Lucia, Katie Keith and Olivia Hoppe

On October 3, Nevada opened its new state health insurance market for Window shopping, After years of using HealthCare.gov, Nevadans can receive financial help and health plans via Nevada Health Link Beginning November 1, 2019. Next year New Jersey and Pennsylvania will follow in the footsteps of Nevada, and New Jersey has announced a big upswing navigator Financing for the transition to the status of a complete state marketplace (SBM). New Mexico and Maine have also announced their intention to move from HealthCare.gov to a state platform, and Oregon Officials are considering it.

Why the sudden interest of the states to give up the federally promoted marketplaces? HealthCare.gov has worked well after all reports. In one new report published in collaboration with the Urban InstituteWe wanted to find out what motivates states to transition to comprehensive SBM, assess the benefits and risks of such transition and identify considerations for other states that are considering a similar move. Important results are:

  • The key factors driving governments to switch from the HealthCare.gov platform to a complete SBM are the prospect of cost savings (and the ability to redirect these savings to other government priorities), improved consumer experience, and more restoration Autonomy over their insurance markets in the wake of federal measures to undermine the ACA.
  • Civil servants, insurers, consumer lawyers and assistants identify several significant risks associated with a transition, including failures or disruptions of the IT system, gaps in coverage or financial support for enrollees and inconsistent federal policy decisions.
  • Respondents identified a number of potential long-term benefits of creating a full state market, including alignment with other public health priorities and the opportunity to conduct more policy experiments, such as: For example, a public option plan or the buy-in of Medicaid.
  • States considering a future transition to a full-fledged market should:
    • Know (and can articulate) state goals;
    • Set realistic expectations;
    • Ensure sufficient lead time for the construction and operationalization of market IT and other infrastructures. and
    • Involved early and often.

In general, states see the transition to an SBM as a natural next step in their broader vision of reducing the number of uninsured and making healthcare more affordable. One respondent said, "States are making that transition because they are committed and want to help people get coverage." All eyes are on Nevada – the first state to transition back to a state technology platform – as an indicator that whether a A stable and efficient market is a viable option. If Nevada and the other study states succeed, more states are likely to consider transitioning to gain more control and flexibility across their markets and potential savings that can be used for other state priorities.

You can read the full report Here, Georgetown CHIR thanks the Robert Wood Johnson Foundation for generous support of this project.

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