"(3) USE OF FUNDS.—A State shall use amounts awarded under this subsection for activities (including planning activities) related to establishing an American Health Benefit Exchange, as described in subsection (b)."

Mar. 23, 2010 - Patient Protection and Affordable Care Act (HR 3590) (2MB)  

"Affordable Insurance Exchanges will provide individuals and small businesses with a ‘one-stop shop' to find and compare affordable, quality private health insurance options.

Exchanges will bring new transparency to the market so that Americans will be able to compare plans based on price and quality. By increasing competition between insurance companies and allowing individuals and small businesses to band together to purchase insurance, Exchanges will help lower costs."

"Health insurance exchanges are the centerpiece of the private health insurance reforms of the Patient Protection and Affordable Care Act of 2010 (ACA). If they function as planned, these exchanges will expand health insurance coverage, improve the quality of such coverage and perhaps of health care itself, and reduce costs…

One valuable role that exchanges can play is to administer subsidies that assist lower- and middle-income people in purchasing insurance… Exchanges are ideally situated to administer these subsidies, as eligibility can be determined during the enrollment process, and the subsidies can be sent directly to the insurance plan chosen by each person."

"Consumers will greatly benefit once an exchange is in place. Here's why:

Competition: An exchange will make the state's insurance market more competitive. The exchange will force insurers to compete for customers based on value, instead of luring them with the trickiest fine print. The exchange will have an easy-to-use website that allows consumers to make apples-to-apples comparisons when they shop for health plans. On this level playing field, quality insurers of all sizes—not just the largest and most powerful—will be able to compete.

Transparency: Insurers in the exchange will have to use easy-to-understand language to describe their products—a vast improvement over the confusing jargon that consumers face now. And insurers will be required to share information about plan costs and quality in a standardized way so that consumers can truly understand what they're getting.

Affordability: In the exchange, middle-class consumers (those who earn up to nearly $90,000 for a family of four in 2011) will be eligible for tax credits to help them pay their insurance premiums.

Many people will also receive help with copayments, deductibles, or other cost-sharing. And the exchange will monitor insurers to make sure that they aren't unreasonably increasing their premium rates from year to year.”

"An Exchange can make health care easier to navigate for consumers and small businesses. It can allow Minnesotans to easily compare health insurance options based on cost, quality, and consumer satisfaction. It can also foster fair and equitable competition to encourage insurers and health care providers to place a greater focus on value and affordability…

An Exchange can help small businesses provide affordable coverage choices to their workers and allow employees to choose the plan that is best for them and their families. Employees will be able to use contributions from one or more employers to purchase coverage for them and their families and keep that coverage if they become self-employed, lose their job, or if they change jobs. An Exchange can also simplify the administration of health insurance for small businesses and allow them to focus on growing their business instead of managing health insurance.”

"The Affordable Care Act helps create a competitive private health insurance market through the creation of Affordable Insurance Exchanges. These State-based, competitive marketplaces, which launch in 2014, will provide millions of Americans and small businesses with ‘one-stop shopping' for affordable coverage.

In the Exchanges, Americans will also have access to a wide range of customer assistance tools – including information about prices, quality, and physician and hospital networks. The plans offered in the Exchanges will be required to provide at least a basic level of comprehensive benefits…

Competitive state Exchanges will keep prices low by:

• Increasing competition among private insurance plans through improved comparative shopping and more informed consumers
• Providing small businesses the same purchasing power in Exchanges as large businesses.

Additionally, the increased competition in the Exchanges--combined with provisions in the law to streamline administrative costs by standardizing forms and reducing the amount of paperwork doctors are forced to complete--will reduce average premiums by 7 to 10%, according to the Congressional Budget Office.

Provisions in the law that prohibit insurance companies from discriminating against Americans with pre-existing conditions will force insurance companies to provide high-quality benefits at a competitive price.”

"Health insurance exchanges are a good idea—if they are used to implement patient-centered and market-based health reforms that enhance choices and value for customers. The exchanges prescribed by Obamacare will have the opposite effect...

Rather than serving as a mechanism for expanding health insurance choice, variety, and competition, and for spurring plans and providers to innovate and offer customers better value, Obamacare exchanges will impose new regulations, administer new subsidies, standardize coverage, and restrict consumer choice and insurer competition more than it is already. Thus, in the PPACA Congress has perverted the exchange concept into a bureaucratic tool for federal subsidization, standardization, and micromanagement of health insurance coverage by the Department of Health and Human Services.”

"The Department of Health and Human Services promises that the creation of government-run health insurance exchanges will give states more flexibility and consumers more choices. But an examination of the rhetoric versus the reality reveals that these claims are just a smokescreen while HHS effectively nationalizes the entire health insurance market...

The initial cost is the loss of state sovereignty. While no state is required to operate a health insurance exchange, if it fails to initiate one by January 1, 2014, ObamaCare authorizes Secretary Sebelius to step in and do so. In the latter scenario, a state would be unilaterally cut out of any policymaking decisions regarding the portion of its residents that fall within the federal exchange's targeted consumer base...

Health insurance companies must meet certain standards to become qualified participants in the government-run exchange.

But because ObamaCare creates tax incentives and subsidies for purchasing plans on the exchange, many companies rightly fear that failing to qualify as participants will ultimately harm their businesses since those benefits are not extended to plans offered outside the exchange.

Thus, with the advent of government-run exchanges in 2014, the entire health insurance industry will be competing to please Secretary Sebelius and her army of HHS bureaucrats, not the millions of consumers compelled by the tax code to buy a one-size-fits-all health plan.”

"Running their own exchanges won't empower states to prevent both the most economical and the most comprehensive health plans from disappearing from their markets. Affordable plans will disappear because Obamacare requires all purchasers to buy whatever coverage Sebelius mandates as ‘essential,' a definition that will grow ever broader, as such definitions always do. The law's price controls will require insurers to charge everyone of a given age the same premium, regardless of whether an actuarially fair premium might be $5,000 or $50,000. Even state-run exchanges would see comprehensive health plans crumble under the weight of too many patients who cost $50,000 but pay far less. Nor can state-run exchanges prevent other dimensions of quality from eroding. Even in state-run exchanges, the sickest patients would struggle to get their claims paid by insurers who are trying to avoid, mistreat, and dump them, because that is what Obamacare's price controls reward.

States that run their own exchanges will likewise be powerless to prevent HHS from loading health-savings-account (HSA) plans down with mandated benefits.”

"The health insurance exchanges defined in PPACA won't work, won't increase access to affordable health care, and won't do anything to improve health outcomes or increase value. The solution to affordable coverage isn't to be found in these new bureaucracies, but rather in reducing barriers to competition and consumer choice and removing regulations that make coverage unaffordable today…

PPACA's solution is to combine an individual mandate with health insurance exchanges, forcing consumers to choose from a limited slate of homogenized health plans, with federal subsidies available to some to offset the high cost of the plans.

PPACA's solution is fundamentally flawed and unsustainable: It will limit choice, create new bureaucracies, cost consumers and taxpayers more, and put additional burdens on the states.”

"We're not going to implement the health care exchanges because it's not going to drive down the cost of health care, it's going to raise the cost...

The problem with the exchanges is the government is going to dictate the type of policies. The policies that will be on there are the kind of policies you might not want to buy…”