While also supportive of design flexibility, Stephen Finan, senior policy director of the American Cancer Society Cancer Action Network, noted in a statement that with flexibility "comes a responsibility for states to create exchanges that meet the wide-ranging needs of people with cancer and other life-threatening chronic diseases." He added that ACS-CAN hopes that the final rule "will include more specifics that define the minimum standard for an effective exchange."
The role HIX are expected to play in helping to reduce healthcare costs was noted by Terry Gardiner, vice president of policy & strategy for the Small Business Majority. "The most important component of healthcare reform for small businesses is the creation of state health insurance exchanges. They will lower the high cost of insurance premiums and reduce the administrative costs that are so often the driving force behind skyrocketing rates for small group plans, "Gardiner said in an email.
The governance of health insurance exchanges was on the mind of several groups. PIRG's Russo stated that HIX "must be run by and for businesses and consumers, not by and for the insurance lobby." He added that HIX need to have the "power to negotiate for lower premiums and push for reforms that improve the quality of care. As our exchange board members begin to set policies and build the exchange, they should focus on delivering results for consumers."
There was some disagreement concerning how health plans should be selected to participate in HIX. ACS-CAN's Finan said, "exchanges should be empowered to select which plans they offer and to limit exchange participation to high quality plans." AHIP, on the other hand, supports a wide panel of health plans in each exchange as long as the plans meet the standards set forth in the draft rules.