From A to W: Foundation Breaks Out Health Exchange Implementation

A state also can decide how open it wants to be to insurers and brokers.

A few states have taken aggressive steps to say they will not have anything to do with the exchange program, but most states have taken $1 million federal exchange planning grants. States can use the $1 million grants to look into the idea of participating in the exchange program, even if they decide against doing so.

In Alabama, for example, Gov. Robert Bentley, R, has issued an executive order creating an Alabama Health Insurance Exchange Study Commission to recommend how Alabama should establish a health insurance exchange, the Kaiser analysts said.

An exchange establishment bill failed.

The study commission is supposed to submit recommendations about the exchange program to the governor and lawmakers by Dec. 1.

In Wisconsin, the state Department of Health Services received a $1 planning grant in September 2010 and a federal “Early Innovator” grant for about $38 million in February.

There, Gov. Scott Walker, R, has issued an executive order creating the Office of Free Market Health Care which is supposed to “conditionally develop a plan for the design and implementation of a Wisconsin health benefit exchange that utilizes a free-market, consumer driven approach.”

Wisconsin has indicated that it will establish its own exchange, and it is using the Early Innovator grnat to build an exchange prototype with help from the vendors that will be hired, the Kaiser analysts said.

The analysts noted that Wisconsin also plans to use subcontractors to help with exchange marketing.