Insurance exchanges, or “Gateways” as they are called in the Senate HELP bill, are a key element in all of the congressional health reform proposals, as well as the proposal outlined by President Obama in his speech to Congress. The exchange is not some new heavy-handed government regulatory body. Rather, the purpose of the exchange is to make the private market work better and more efficiently.
In this post, I set forth several design principles and insurance market reforms that are necessary if the exchange is to achieve its desired objectives. I then discuss how well these criteria are met in the health reform bills approved by the Senate Finance Committee, the Senate Health, Education, Labor, and Pensions (HELP) Committee, and three committees in the House of Representatives.
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