Passive/Active: Defining the Role for a Health Benefit Exchange in the Interests of New Yorkers

Author/Editor: Peter Newell and Robert L. Carey

The roles that New York’s health benefit exchange should play range from that of a passive marketplace with the free market alone determining the quantity and scope of offerings, to that of an active purchaser, with the exchange using its leverage to achieve one or more systemwide goals.

Passive/Active: Defining the Role for a Health Benefit Exchange in the Interests of New Yorkers, written by Peter Newell and Robert L. Carey, explores the pros and cons of the various models for the exchange along the continuum between these two different approaches. The report outlines the relevant Affordable Care Act requirements for exchanges, provides context for the debate based on activities in other states, explains how the core exchange activities are affected by unique features of New York’s insurance market and regulatory framework, and lays out the policy options in the passive/active framework under the various exchange models.

Passive/Active is the fourth in a series of health benefit exchange-related research projects by the Fund that are supported by the New York State Health Foundation. Previous reports addressed the infrastructure and governance for the state exchange, integrating Medicaid with new subsidized commecial coverage, and pooling mechanisms for individuals and small groups. All are available from the Fund’s website (links below).

Read the related press release.

Read the first report in this series, Building the Infrastructure for a New York Health Benefit Exchange: Key Decisions for State Policymakers.

Read the second report in this series, Coordinating Medicaid and the Exchange in New York.

Read the third report in this series, Two into One: Merging Markets and Exchanges under the Affordable Care Act.

Read the fifth report in this series, Defining Essential Health Benefits: Federal Guidance and New York Options.

Copyright: 2011
Published: 12.19.2011

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• Passive/Active: Defining the Role for a Health Benefit Exchange in the Interests of New Yorkers (3718KB)