Building the Infrastructure for a New York Health Benefit Exchange: Key Decisions for State Policymakers

Health insurance exchanges are the centerpiece of the public and private insurance reforms included in the Federal health reform law. This NYHealth-supported report from the United Hospital Fund examines the critical, complex choices that New York State faces in establishing a successful exchange.

The report addresses such key questions as whether New York should establish its own exchange or allow the Federal government to establish one for New Yorkers; discusses the type and scope of possible exchanges; and presents a detailed assessment of structural and governance issues for implementing an effective exchange.

Read the report.

For another view on establishing exchanges in New York State, read the Manhattan Institute report.

This report is the first in a series of reports focused on New York’s Exchange. The second report examined the organizational improvements necessary to successfully integrate the State’s Medicaid program into the Exchange. The third report focused on two discretionary decisions for New York involving the Exchange: merging the exchanges for individuals and small businesses and merging the individual and small group markets. The fourth report explored the roles the Exchange should play, ranging from a passive market organizer model to an active purchaser. The fifth report examined the various plan options that will serve as a benchmark plan for implementing the essential health benefits rule required for all individual and small group policies. The sixth report looked at the extent of public and private health insurance plans’ provider networks and current State standards and processes for determining the adequacy of these networks.