When Democrats decided to call the new insurance marketplaces created by the health reform law “exchanges,” they didn’t exactly do themselves a favor. The idea of a health insurance “exchange” has never really caught on; it doesn’t conjure up anything specific in the minds of Americans. Because of that, some health reform advocates have recommended forgoing the term altogether, instead calling the exchanges “marketplaces.”
“The public gets a ‘marketplace’,” the Herdon Alliance, a pro-health reform strategy firm, wrote in a February 2011 memo. “They remain confused by an ‘exchange.’”
The conventional definition of a health insurance exchange is a state-run Web site where individuals can shop for and purchase coverage. But that probably doesn’t mean much to many Americans either. The best way to get a handle on the concept of a health insurance exchange is to see what one looks like. This afternoon, Minnesota gives us a chance to do that: the state just released a set of five prototypes — drawn up by a consulting firm — for what its exchange could look like in 2014. Here’s how health consulting firm Curam imagines it:
And another one from Ceredian, which models a possible exchange for small businesses and their employees:
Click through to the Minnesota Department of Commerce site and you can play around with the module simulations, which ask questions about where you live and how much you earn to determine what health benefits you might be eligible to receive.
Minnesota still hasn’t figured out what exactly its final exchange will look like. Since every state has the opportunity to design its own exchange, most will probably look somewhat different. Utah and Massachusetts, the two states that now operate exchanges, show how different marketplaces could look.
On the back end, states have a lot of decisions to make about their health exchanges as well. They need to determine whether they’ll operate the marketplace or leave the task to the federal government, if they’ll limit the exchange to a set number of insurance companies or allow anyone who meets some baseline requirements to participate. But as it relates to consumers, an exchange is a jargony word for a pretty simple concept: A state-run Web site where people can buy insurance.