As legislative sessions wrap up around the country, so does the first full legislative opportunity for lawmakers to pass a state-based health exchange since the signing of the Affordable Care Act into law. Over the weekend, the state of Connecticut joined nine other states that have already passed legislation to enact state-based marketplaces to improve the health security of families, a key piece of the federal health law. Exchange legislation has already been passed by Washington state, Maryland, California, Massachusetts, Colorado, Hawaii, Vermont, West Virginia, and Oregon.
Connecticut lawmakers worked hard to pass legislation to create a strong exchange that will ensure consumer-friendly outcomes. SB 921  creates an exchange in the “active purchaser”  model, one that has been previously followed in states like California and Massachusetts, allowing the state to protect consumers and negotiate in their best interest. In addition, other strong provisions in the Connecticut legislation address possible conflicts of interest around insurance carriers and providers serving as either employees or on the board of the exchange.
While the bill includes mandates for the benefits offered by plans in the exchange, they also responsibly require a study of that language once the essential benefits package is defined by the federal Department of Health and Human Services, an announcement currently scheduled for this fall. State Rep. Robert Megna (D) praised the benefits  of the bill, noting that “it offers new tools for comparing health plan options, encourages competition among providers on price and quality and moves toward a goal of coverage portability.”
By the time it is implemented in 2014, Connecticut’s state-based exchange may also include a public option if the newly created Governor’s cabinet for the SustiNet health care program finds it fiscally viable to implement.
Another bill passed by the Connecticut legislature, HB 6308 , calls for the cabinet to create a business plan for SustiNet in the upcoming years to assess the feasibility of providing a state-based public option. More immediately, the bill will allow local municipalities to buy-in to the state pool starting in 2012, and it will allow nonprofits that contract with the state to buy-in to the same pool in 2013, in effect creating a quasi-public option for employees of municipalities and some nonprofits.
While Connecticut’s exchange legislation did not ultimately include everything advocates desired, it is an important step in the right direction, giving options to consumers and extending coverage to many who desperately need it. As each state navigates its own path on health care exchanges, the passage of Connecticut’s legislation provides an example for other states interested in creating strong, active marketplaces  that will provide greater coverage and choice for families. It is also further evidence of the momentum continuing to build behind implementation of the Affordable Care Act in the states.
Full Resources from this Article
Timothy Jost, Health Affairs Blog – Implementing Health Reform: Emerging Guidance On Insurance Exchanges 
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