Health Insurance Exchanges

Health Insurance Exchanges Working Group

This University of Pennsylvania research group began in 2012, with the recognition that the Affordable Care Act’s success depended largely on successful implementation of its reforms in the individual insurance markets or "exchanges". These reforms were rolling out state-by-state with little evidence to guide decisionmaking. With that, Penn's Leonard Davis Institute of Health Economics (LDI) created the HIX working group that focused on implementation of the health insurance exchanges. This working group, led by Tom Baker, JD, continues to bring together experts from the Law School, Wharton, Medicine, Arts & Sciences, and Children's Hospital of Philadelphia, as the implementation of health care reform has evolved over time.

The group has been funded by the Sloan Foundation and the Robert Wood Johnson to sustain robust research portfolios in narrow networks, insurance regulation, choice architecture, and decision support. Funding also supports a high-impact annual conference that brings together researchers, government officials, and industry leaders to learn from each other as this system of exchanges develops. The Fifth Annual Conference was held on September 14-15, 2017. 

LDI has developed a brand for its presence in this area, particularly its leadership around understanding the emergence of narrow networks through its Narrow Networks Project. This work has appeared often in the New York Times and other major media outlets and has led to several high-impact publications from LDI researchers and researchers around the country. HHS policies have been developed based on our work and we now have a network of nearly 100 industry and research experts from around the country engaging with our data and findings.

First Health Insurance Exchanges Conference

It was April 11-12, 2013. The ACA’s Health Insurance Exchanges were scheduled to go live in six months, and 14 states had chosen to develop their own online marketplaces rather than participate in the federal Healthcare.gov. With funding from the Sloan Foundation, LDI brought nearly 100 researchers and policymakers together at the first Penn LDI Health Insurance Exchanges Conference. The air was filled with excitement and uncertainty. Guest blogger Austin Frakt captured some of the conversations in a series of short posts. Researchers talked about choice architecture and optimal exchange design and health plan competition; state exchange officials had more immediate and practical concerns, stating, “We’ll just be happy if the lights go on.” In retrospect, they had reason to worry.

The conference was so successful that it became an annual event, drawing support from the Robert Wood Johnson Foundation and spawning longstanding collaborations between researchers and policymakers. Check out coverage of the 2014 conference here and last year's event here. The Health Insurance Exchanges (HIX) Research Group, led by Tom Baker and Bob Town, continues to produce policy-relevant research that informs how consumers shop for health insurance in the individual marketplace. While the fate of health reform is uncertain, the demand for the conference is not; the fifth annual HIX Conference will be held September 14-15, 2017. Details and agenda here.