Beginning in 2013, states will begin rolling out health care insurance exchanges as required by the Affordable Care Act (ACA). To this point most legislators, policymakers and health care experts have discussed the state-based and federal insurance exchange options at length. However, there is another form of insurance exchange that states are beginning to explore, and will soon be implemented in Illinois: the “partnership”.

In the state-federal partnership, states will divide obligations with the federal government. For this partnership model there is no requirement for a 50-50 split of labor, and the states are actually more of a facade whereby the consumers (individuals and employers) merely interact with the state. The federal government, on the other hand, will essentially perform all functions of exchange management except customer service and/or plan management. Moreover, states have the choice to run either one or both of those functions. According to former head of insurance exchange planning at HHS Joel Ario, “States that choose this option are ceding the more technical aspects of exchange activity to the federal government but can retain control
 of insurer oversight and consumer assistance.”

In the state-federal partnership model, the federal government will operate everything from consumer eligibility and enrollment to financial management and risk corridors. This essentially means that the federal government will take on most responsibility for the exchange, while granting states many of the perks they would receive if they had created a state-based exchange.

To date, only a few states have revealed that they intend to participate in a state-federal exchange. Here in Illinois, Governor Pat Quinn announced intention to run a partnership exchange in July of 2012. Since that announcement, the state has already received $39 million for the state, and this sum does not include monies issued for Medicaid expansion.

Currently, the Department of Health and Human Services (HHS) has written very little about this vague “partnership,” leaving many in Illinois wondering exactly what the collaboration will look like and how consumers will respond. The only known is that beginning in 2013, Illinois will embark down a new path for getting health care insurance to its citizens, and that will be facilitated through an exchange.

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