The Department of Health and Human Services has established the minimum set of benefits health benefit exchanges can offer prospective members, as well as a baseline of functionality that must be provided. But does anyone believe that exchanges will stick to only the prescribed structure?  I’m not talking about future generations of exchanges, but the very first that will hit the market.

The configuration of the first-generation HBEs is also going to be influenced by the model of competition adopted by the states (one or multiple exchanges with open competition) and the states’ scope of involvement in the exchange(s) beyond simple monitoring exercises. If a state adopts a multi-exchange model, rest assured that the amount of functionality offered will be much larger than in the case where a state offers up a single, tightly-controlled exchange.

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