State flexibility key issue in health law implementation

The Washington Post reports on how some states want to move past the 2010 measure in advancing their own health reforms. Meanwhile, as states build their health insurance exchanges, a key variable will be the degree of competition within their own insurance marketplaces.

The Washington Post: Some States Seek Flexibility To Push Health Care Overhaul Further
A handful of states are pursuing health measures that go far beyond the Obama administration's signature legislative accomplishment, the Affordable Care Act. They stand in contrast to Republican governors, who have aggressively opposed the law. Twenty-seven states are challenging the law in the courts as unconstitutional, while two, Florida and Louisiana, have just refused to implement much of the law (Kliff, 10/16).

CQ HealthBeat: Exchanges Face Concentrated Markets, Study Finds
The health care law aims to spur competition among insurers to lower premium costs for individuals and small employers by creating state health insurance exchanges, but in many instances, there aren't that many insurers around to compete, a new study suggests. The study by the Kaiser Family Foundation finds that "while substantial variation exists ... the current insurance markets in many states are highly concentrated with only modest competition." States should consider how hotly contested markets are in deciding how to perform health care law functions such as building exchanges and reviewing insurance rates, the study says (Reichard, 10/14).

California Healthline: Health Care Reform For Small Businesses
The number one key to success for small businesses in the state's Health Benefit Exchange is choice, according to several presenters at a panel discussion last week in Sacramento (Gorn, 10/17).