Massachusetts and Utah: The Original Pioneers of the HIX

Published: February 05, 2013

Acquisition ReformHealth CareHealth IT

The goal of President Obama’s Affordable Care Act (ACA) was to put people in charge of their health care instead of insurance companies. With the act, states are expected to establish health insurance exchanges (HIXs) to serve as a central marketplace for people to compare health plans based on rates, benefits and quality. The objective is to give people wider access to customer assistance tools, in addition to better choices in health care plans. States must have these HIXs up and running by January 1, 2014.
Massachusetts and Utah are two states that saw the importance of getting people insured long before the ACA was legislated. Both states successfully implemented online marketplaces for consumers and small businesses to purchase health plans; however, their stories are very different. 
On April 12, 2006, Massachusetts passed legislation for the Health Connector, a system that would provide affordable insurance to qualified individuals. Computer Sciences Corporation (CSC) was awarded a five-month contract to build and design the state’s Health Connector website, which was based on program processes and customer needs.
A few years later, Utah approved legislation to establish an exchange in March 2009. After a year-long assessment, the state selected bswift LLC to serve as its exchange administrator. The exchange launched in August 2009 and provided consumers with information on health care financing, a means to compare and purchase health plans, and standardized enrollment systems facilitated by a universal insurance application. Bswift was responsible for providing online health plan enrollment and administration technology.
Today, both states are moving along with initiatives to implement ACA-compliant health insurance marketplaces. Massachusetts, an Early Innovator Grant recipient, has received $98.8 million in federal funding under Exchange Establishment grants. The state is taking a two-step approach to implement its health insurance exchange and integrated eligibility system. Utah’s current exchange covers 7,600 people and is utilized by more than 300 businesses. Governor Herbert is having discussions with the Department of Health and Human Services (HHS) regarding needed enhancements to the current system, which he would like to maintain.
So far, 18 states including Washington D.C. have received federal approval to set up a state-based health insurance exchange. States have until February 15, 2013 to submit plans to implement a partnership exchange. Only a few have received federal approval thus far in moving forward with this model. To read the full report on Massachusetts and Utah’s health insurance exchange efforts, go here.