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California's Insurance Exchange: Experts Tackle the Big Questions

Health policy experts in Sacramento hash over details and discuss trade-offs in designing and implementing the state's health insurance exchange in the context of health reform.

Health policy experts gathered in Sacramento to discuss the establishment of California's health benefit exchange within the context of the federal Affordable Care Act (ACA). Hosted by CHCF, the briefing was held in Sacramento on October 21, 2010.

"We're having a conversation today that is not occurring in any other state," Secretary of Health and Human Services Kim Belshé said in her opening remarks. "We're talking about [health care] reform, and not just reform in terms of the big ideas, but reform in terms of implementation." In addition to Belshé, the panel included policy experts associated with the California legislation as well as with other insurance exchanges such as the Massachusetts Connector. The speakers and their topics follow:

Jon Kingsdale, an independent consultant and former executive director of the Massachusetts Connector, discussed the potential goals of the California exchange and ways the state can benefit from the Massachusetts experience.

Ed Neuschler, senior program officer at the Institute for Health Policy Solutions, discussed the federal law as a framework for the California exchange.

Sumi Sousa, special assistant to California Assembly Speaker John Perez, laid out the scope of the California legislative team's work — designing a structure, governance mechanism, and a self-supporting financing arrangement.

Scott Bain, principal consultant, Committee on Health, California State Assembly, discussed policy considerations that included ways to make the market work well for consumers and to reduce adverse selection.

Jennifer Kent, deputy legislative secretary, Office of Governor Arnold Schwarzenegger, described the exchange governance structure and issues of transparency.

Patrick Holland, with Wakely Consulting Group and former chief financial officer with the Massachusetts Health Connector, talked about designing the procurement process to make the exchange attractive to both consumers and insurers.

Rick Curtis, president of the Institute for Health Policy Solutions, discussed the creation of rules that would protect the interests of all parties so that market forces would reward both efficiency and better health care.

The issue brief summarizes the presentations of the panelists, offers a synopsis of the California legislation, and identifies remaining implementation issues. The complete issue brief is available as a Document Download.

More information about the briefing, including presentation slides and a transcript of the event, are available through the links below.

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