Representatives from nearly every state are deeply torn over the proposed health care reform. With strife growing in Congress, it seems that the only provision of the new law that can be agreed upon is the provision for insurance exchanges. Almost all states are making moves to implement exchanges, the only ones lagging behind doing so simply are because of lack of appropriate funds.
Making the changes necessary to facilitate an exchange program are somewhat demanding. Many states have seen downsizing in their staffing and the workload often piles up on a single individual. Regardless of this, representatives are eager to forge ahead and improve the quality of care for their constituents as well as the fairness of the insurance market.
To enact the new legislation, states will face a number of challenging decisions. They will have to determine whether the exchange program will be regulated by a state-run agency or by an independent one. They will also have to decide whether there should be separate programs for individuals and small businesses or to simply have one program cover both parties. Officials must also decide whether to provide marketing assistance to insurance companies or to let them do all the work themselves.
Perhaps the most important decision of all is how states will decide to regulate the insurance industry. Tighter regulations and more governmental involvement would mean that the state would have the ability to negotiate for the lowest premiums, but it could push insurers out of the market as they will be unable to offer quality coverage for a minimal amount of money.
Other exchange programs would function as a means for individuals to find coverage they can afford that they would have never been able to find by themselves.
What route states decide to go is entirely up to the discretion of their representatives. The federal government has established a deadline for programs to be fully functional by January 1, 2014.