Wednesday, May 16, 2012
Health Care Experts Blog

Contributor

Alan Weil

Biography provided by participant

Alan Weil has been NASHP's executive director since September 2004. Mr. Weil previously served as director of the Urban Institute's Assessing the New Federalism project, one of the largest privately funded social policy research projects ever undertaken in the United States. He previously held a cabinet position as executive director of the Colorado Department of Health Care Policy and Financing, was health policy advisor to Colorado Governor Roy Romer, and was assistant general counsel in the Massachusetts Department of Medical Security. Mr. Weil is the co-editor of two books, publishes regularly in peer-reviewed journals, and has testified before Congress more than half-a-dozen times. He is on the editorial board of the journal Health Affairs, and is a member of the Institute of Medicine's Board on Health Care Services, the Commonwealth Fund's Commission on a High Performance Health System, and the Kaiser Commission on Medicaid and the Uninsured. He is a graduate of the University of California at Berkeley, the John F. Kennedy School of Government at Harvard University, and Harvard Law School.

Recent Responses

January 19, 2010 08:06 AM

While basic principles of federalism don’t provide an unambiguous answer to whether insurance exchanges should be run by the states or the federal government, those principles can help us consider the relative merits of the two approaches.

In order to be effective, exchanges will need access to specialized expertise – actuarial, market research, and the like. Generally, the federal government is more able to obtain such expertise and it is more efficient for the federal government to do so than it is to have each state seek it on its own.

A single national exchange will be more efficient for large, national insurers. Even my small organization has employees who live in five different jurisdictions; we would probably find it easier to interact with one national exchange than five separate ones. Concerns regarding risk selection against the exchange are probably easier to mitigate in a national pool.

A key feature of an effective

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