Designing an Exchange: A Toolkit for State Policymakers


Designing an Exchange: A Toolkit for State Policymakers


This legislative toolkit, from the National Academy of Social Insurance (NASI), can assist State policymakers with the design of health insurance exchanges, a key element of the Patient Protection and Affordable Care Act (ACA). It was developed by a panel of experts from a variety of disciplines and perspectives and builds on the model law released by the National Association of Insurance Commissioners (NAIC).

The toolkit includes legislative language with alternatives and additions to the NAIC model act. The NASI legislative language offers options in a number of key areas, including exchange governance, establishment of a Small Business Health Options Program (SHOP) for small employers, eligibility determination and enrollment, certification of qualified health plans, and coordination with Medicaid and the Children’s Health Insurance Program. It also includes a section-by-section guide that documents NASI’s additions to the NAIC language and a narrative discussion of the concerns that motivated the alternatives presented.


National Academy of Social Insurance

Funding Sources:

Robert Wood Johnson Foundation


Release Date: 2011
Original Summary: May 2012
Last Updated: 11/28/12

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