A new report from the Urban Institute examines reasons for two or more states to consider combining resources to create a multi-state health insurance exchange under the health care reform law.
The report explains four rationales for multi-state exchanges; administrative economies of scale, better service of large metropolitan areas that cross state lines, promoting pooling across state lines, and creating a critical mass of insured persons to stabilize risk pools in low-population states.
One scenario that likely won't play out is cross-state risk sharing, as that could lead to one state's population effectively subsidizing another state's population, the report concludes.
The report, funded by the Robert Wood Johnson Foundation, is available
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