Updated at 8:13 a.m. on Jan. 19.
Should Congress settle on a single, national health insurance exchange or individual state exchanges in its final health care reform legislation? Negotiations seem to be leading to a single, national exchange.
The House-passed bill calls for the federal government to operate a single, national health insurance exchange. Advocates argue that state-run exchanges could be too small to be effective and wouldn't account for varying needs in different parts of the country.
The Senate-passed bill, meanwhile, would direct states to run individual exchanges. The National Association of Insurance Commissioners backs this idea, arguing in a Jan. 6 letter to Congress that consumers are "best served by insurance regulation that is located firmly at the state level."
Who's right? And what do we already know about state insurance regulation that should influence Congress' decision?