The much-anticipated California's health insurance exchange may well end up being a model for other states to follow—but there's no guarantee they will rush to imitate the Golden State's handling of that key aspect of Obamacare, health care analysts said
Instead, observers said, other states that are already on track to implement their own insurance exchanges are likely to take a wait-and-see approach on whether they should adopt details of California's exchange—which to much fanfare last week revealed the names of 13 insurance plans that will begin proving coverage to individuals in 2014.
Those details include a so-called "active" approach by the state in negotiating with insurance providers to make premiums for individuals more affordable. They also include California's making sure there are standard benefits within four coverage categories so people can make an "apples-to-apples" comparison when deciding which plan makes the most sense price-wise.
"In terms of replicability, I don't know if it [California's insurance exchange] will replicated in year one, because the cake is sort of baked in year one, and it will take some time for other states to get over not just their technical but their political hurdles," said Anthony Wright, executive director of Health Access California, a statewide health-care consumer advocacy coalition.
"There's stuff that can be replicated, but it may not be this year. My hope is that for at least some of the exchanges, they can see what California did out of the box and make some changes," Wright said.
California was early to announce it would implement a state-based marketplace for health insurance under the Affordable Care Act.
And it is just one of 16 states, along with the District of Columbia, on track to operate such an exchange—which is supposed to give people and small businesses a choice of competitive and affordable health insurance packages.
(Read More: Want A Glimpse of Obamacare? Look at Massachusetts)
Other states opted out of that state-based model—at least for now—and are relying on a federally-facilitated exchange to provide people with that coverage, or entering into a partnership with the federal exchange.
The Golden State's size, its early embrace of Obamacare and the fact that it will represent a significant fraction of Americans eligible for state-based insurance exchanges have focused attention on California's exchange. Up to five million people could sign up under California's exchange.
"Over the past year or two of the process leading up, I've had more awareness of what's going on in California than in other states," said Paul Ginsburg, president of the Center for Studying Health System Change, based in Washington, DC.
Ginsburg noted that most states planning a state-based exchange "so far have used the passive model" in choosing insurance plans to participate, letting plans decide whether they want to opt in to their exchange, instead of setting up hurdles such as negotiated rates that could keep them out or discourage them from participating.