Christine Ferguson, director of the Rhode Island Health Benefits Exchange, says she expects to see a big shift to state control in the next few years. ‘‘Many of the states have just run out of time for a variety of reasons,’’ said Ferguson. ‘‘I'd be surprised if in the longer run every state didn’t want to have its own approach.’’
In some ways, the federal government has a head start on the states. It already operates the Medicare Plan Finder for health insurance and prescription plans that serve seniors, and the Federal Employees Health Benefits Program. Both have many of the features of the new insurance markets.
Administration officials are keeping mum about what the new federal exchange will look like, except that it will open on time and people in all 50 states will have the coverage they’re entitled to by law.
Joel Ario, who oversaw planning for the health exchanges in the Obama administration, says ‘‘there’s a rich dialogue going on’’ as to what the online shopping experience should look like. ‘‘To create a website like Amazon is a very complicated exercise,’’ said Ario, now a consultant with Manatt Health Solutions.
He thinks consumers should be able to get one dollar figure for each plan that totals up all their expected costs for the year, including premiums, deductibles and copayments. Otherwise, scrolling through pages of insurance jargon online will be a sure turn-off.