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Public Health Insurance Exchanges/Private Exchanges

Why Employers Care

On March 23rd, 2010 President Obama signed into law the Patient Protection and Affordable Care Act (Affordable Care Act) which included a provision to create state-based health insurance exchanges (exchanges) to expand health insurance coverage. The federal government requires the states to establish exchanges that must be fully operational by 1/1/2014. States have the option of creating their own health insurance exchange, deferring to the federal government or partnering with the federal government on a state-federal partnership exchange.

Though large employers will not be able to offer exchange coverage to their employees initially and may not be able to do so in future years if states do not allow them to, exchanges are important to large employers for several reasons. Specific populations, such as early retirees, some dependents, and COBRA eligible individuals may find coverage through exchanges, all employees will be comparing their employer coverage to exchange coverage and the small employer exchange rules may ultimately apply to large employers in the exchanges.

In addition to public health insurance exchanges, private exchanges have recently been receiving a lot of interest from employers. Private exchanges have been around for a number of years for Medicare-eligible retirees. Whether spurred by the ACA or not, consultants, insurers and others have dived into the private exchange arena and created private exchanges that focus on a broader array of benefits-eligible and -ineligible populations than Medicare-eligible retirees, including active employees.

The National Business Group on Health (Business Group) believes that the exchanges must aggressively focus on value, reduce the total cost of the coverage and care for all people and all payers, and improve the quality and safety of service for enrollees. The Business Group maintains multiple sets of resources on both public and private exchanges. Please see below for more information.

What Can Employers Do?

As members of the National Business Group on Health, employers can contact the Business Group's public policy team with concerns and to receive more information on public or private health insurance exchanges.

Relevant Tools and Resources Include:

Page last updated: January 29, 2014

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Private Health Insurance Exchanges