This week in Washington—how partnership marketplaces will work. You are tuning in to the second installment of the health policy update from America’s Essential Hospitals for the Week of Sept. 16.
Two weeks from now the new health insurance marketplaces will start helping people shop for and sign up for health insurance. As we have discussed in the past two podcasts, marketplaces in different states will do this in different ways, depending on whether they are run by the states, the federal government, or as a partnership between the two. Today we will discuss how partnership marketplaces will work.
Partnership marketplaces are marketplaces where the federal government oversees most marketplace activities, but the state has authority to define two key marketplace activities: certifying health plans and conducting outreach and enrollment.
First, a partnership marketplace allows a state to determine which plans will be certified as “qualified health plans” that can be sold through the marketplace. This means states will have more say in what services and providers are included in plans sold through the marketplace. States will develop the requirements that plans must meet to be sold through the marketplace, as long as the requirements comply with federal laws. States will then review and decide which ones will be able to be sold. States will also oversee and monitor the plans to make sure that they continue to comply with the state’s requirements.
Second, in a partnership marketplace, the state will conduct outreach and enrollment activities. States will oversee consumer assistance programs like the navigator program, which trains and certifies people to help consumers understand what coverage and subsidies they are eligible for through the marketplace. This means that states will have the ability to work with organizations that have experience working with local residents and know how to best communicate with them.
Overall, partnership marketplaces give states an opportunity to certify marketplace plans that include the services and providers that are important for their residents. They also allow states to partner with organizations that have expertise working with local residents, especially people who face barriers to accessing information, such as people who do not speak English. As a result, states can help more people get health insurance that covers the care they need from the providers they choose.
Thanks for listening to another edition of This Week in Washington. I’m Erin Richardson; join us next week as we continue our discussion of health insurance marketplaces.