The Commonwealth Fund has just released a report (http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Sep/Health-Insurance-Exchanges-and-the-Affordable-Care-Act.aspx) on the eight difficult issues that have to be resolved in the creation of health insurance exchanges.
Of the eight issues, the most important one is guarding against adverse selection. If the exchanges only attract the least healthy risks, they certainly will fail. Therefore it is imperative that the same kinds of policies be offered both in and outside of the exchange to guard against this.
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