Health Affairs

The Multi-State Plan Program

Bethesda, MD --A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation discusses the Multi-State Plan Program created under the Affordable Care Act. Under the program, at least two health insurance plans choosing to participate will offer coverage through every state-run, federally facilitated, and partnership exchange created under the law. Insurance companies meeting the eligibility criteria have until March 29, 2013, to submit applications to participate in 2014

The program was created to enhance competition among health plans within the new exchanges. It will be administered by the federal Office of Personnel Management, or OPM, which also administers the Federal Employees Health Benefits program offering coverage through a variety of health plans.

This policy brief describes issues surrounding the implementation of the Multi-State Plan Program. Topics include the following:

• Program specifics: OPM must certify that at least two issuers are able to sell coverage in the exchanges by October 1, 2013. The multistate issuers must offer plans in at least 60 percent of states on January 1, 2014, expanding to every state and the District of Columbia within four years. By law, at least one issuer must be a nonprofit, and one must not offer coverage for abortion services.
  
  
• What are the concerns? It is unknown whether the Multi-State Plan Program will actually increase competition among health plans, as there is concern that competitive advantage may go to large insurers that already have a presence in many states. Also, major regulatory and other conflicts remain to be resolved between the states and federal government.
  
  
• What's next? With the final applications from insurance companies due this coming Friday, it will soon be clear how much interest health insurance companies have in participating in the Multi-State Plan Program.

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at www.healthaffairs.org. Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.