The Robert Wood Johnson Foundation (RWJF) recently released four reports jointly prepared by the Urban Institute and the Center on Health Insurance Reforms (CHIR). The reports track health reform implementation in ten states: Alabama, Colorado, Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island, and Virginia. The latest reports focus on early market reforms, state insurance exchange development, insurance rate review, and plan participation and competition within the exchange.

The first brief reports that early insurance market reforms are being implemented in all 10 states with the encouragement and efforts of state officials, insurers, and consumer advocates. The second report found that although exchange implementation progress varies widely across the states, many advocates, policymakers, and stakeholders have been highly involved in the process. The third brief found that most states seem to view the Affordable Care Act’s (ACA’s) insurance rate review provisions as an opportunity to foster accountability for insurers and educate consumers regarding rate increases. The fourth brief reports that markets with a dominant insurer or hospital are less likely to see augmented plan competition under the ACA. However, those without such a dominant plan will likely see increased competition, which could thus lead to lower-premium plan offerings.