Exchanges await more info on Multi-State Plans, express doubt on their ability to foster competition

This recently issued paper on payer participation and competition in the health benefit exchange marketplace authored by the Urban Institute and the Georgetown University Health Policy Institute mentions Multi-State Plans that the Affordable Care Act mandates be rolled out over a four-year period in all state health insurance exchange marketplaces. At least two of these plans must be offered in each state exchange marketplace; one must be a nonprofit and one cannot offer abortion services. On May 30, the White House announced the federal Office of Personnel Management — which will charter the Multi-State Plans that must be licensed in each state — is reviewing applications for more than 200 Multi-State plan options.

Here’s what the paper’s authors write on Multi-State Plans:

State officials in the study states are still waiting for more information from OPM with regard to Multi-State Plans. In general, state officials seem resigned to the fact that the MSP will not necessarily mean more competition, since the MSPs are expected to be national insurers that already have a presence in the states. Informants reported that they have hard time envisioning how, for example, a national Blue Cross Blue Shield plan could come into a state without essentially replicating the Blue Cross Blue Shield products within the state, assuming the MSP would have to use the Blue Cross network and provider payment rates.


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email or call 530-295-1473. 

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Frederick Pilot

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