Patty Pansing Brooks for Congress State Senator “Navigating Exchange Options: Regional, Multi-State, and State-Wide Differences”

“Navigating Exchange Options: Regional, Multi-State, and State-Wide Differences”

May 6, 2025| maia17| 0 Comment| 7:21 AM

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Understanding the Differences Among Regional, Multi-State or State-Wide Exchanges

With the implementation of the Affordable Care Act (ACA) in 2010, the concept of health insurance exchanges was introduced as a way to provide individuals and small businesses with affordable health insurance options. These exchanges are online marketplaces where individuals and small businesses can compare and purchase health insurance plans from various insurance providers.

While the main purpose of these exchanges is the same, there are three different types of exchanges that exist: regional, multi-state, or state-wide exchanges. Each type has its own unique characteristics and understanding these differences is important for individuals seeking health insurance coverage.

Regional Exchanges

Regional exchanges, also known as small business health options programs (SHOP) exchanges, primarily cater to small businesses with less than 50 employees. These exchanges are set up and managed by regions or groups of states and offer health insurance plans specifically designed for small businesses.

One of the main advantages of regional exchanges is that they offer a wider range of coverage options for small businesses, compared to traditional group health insurance plans. As a result, small business owners can select the plans that best suit their budget and needs.

Another benefit of regional exchanges is that they offer lower rates for small businesses due to the larger pool of participants and increased bargaining power with insurance providers. Additionally, these exchanges may also provide access to financial assistance for qualifying small businesses.

Multi-State Exchanges

Multi-state exchanges, also known as the Federally Facilitated Marketplace (FFM), are operated by the federal government and offer health insurance plans to individuals and small businesses across multiple states. These exchanges were created to provide individuals with more choices and competition in the insurance market.

Compared to regional exchanges, multi-state exchanges offer a larger selection of health insurance plans from various insurance providers. This increased competition may lead to lower premiums and more affordable options for individuals and small businesses.

However, one downside of multi-state exchanges is that they may not be available in all states. This means that individuals and small businesses in certain states may not have access to the same wide range of coverage options.

State-Wide Exchanges

State-wide exchanges, also known as state-based exchanges, are operated and managed by individual states. Under these exchanges, each state has the authority to set its own guidelines and regulations for health insurance plans.

The main advantage of state-wide exchanges is that they provide individuals with a more personalized and localized experience, as each stateâ€™s exchange is tailored to the specific needs of its residents. Additionally, state-wide exchanges may offer more comprehensive coverage options, as they are not limited by federal regulations and mandates.

Moreover, state-wide exchanges may also provide individuals with more access to financial assistance and subsidies for those who qualify based on income level.

The drawbacks of state-wide exchanges are that they may not be available in all states and may offer limited coverage options as they are solely reliant on providers within that state.

In Conclusion

In summary, the three different types of exchanges, regional, multi-state, and state-wide, have their own unique characteristics and benefits. Regional exchanges cater to small businesses, multi-state exchanges offer more coverage options and lower premiums, while state-wide exchanges provide a more personalized experience and comprehensive coverage options.

It is important for individuals and small businesses to carefully consider their specific needs and budget when choosing the type of exchange that works best for them. By understanding the differences among these exchanges, individuals can make a more informed decision when it comes to selecting a health insurance plan that meets their needs and provides them with the necessary coverage for their health care expenses.

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Patty Pansing Brooks is a state senator, attorney, small business owner, and lifelong community organizer.

Patty has a proven track record of values-led policymaking and coalition-building to make positive change for all. She was the Co-Chair of the $6 million Union Plaza Fundraising Campaign to create Lincoln’s first urban park. Patty also served as Co-Chair of the $9.6 million Centennial Mall renovation, which helped make the 7 blocks between our Capitol and our State University a beautiful, historic celebration of Nebraska for all visitors. Finally, she was the Co-Chair of the $250 million Lincoln Public Schools bond issue in 2007 with former Senator and friend, Kathy Campbell. That bond issue improved every school in every zip code in Lincoln.”

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In her two terms as a state senator representing Nebraska’s 28th District, Patty has fought hard and achieved victories for our most vulnerable neighbors, particularly children. One focus of her legislative career has been youth justice reform: Patty introduced and passed bills that have expanded children’s rights to legal representation in the justice system, established automatic sealing of children’s court records when they have completed their sentences, and reoriented the purpose of school peacekeeping officers away from bringing more children into the justice system, and toward keeping kids in school.

“Helping people is what it means to be a Nebraskan. More than politics or party, love fuels the fight for real change. When we love our families and our communities — and when someone is in need — we must step in, speak up, and make change happen.”

Additional legislative victories have included protecting victims of human trafficking and enacting stricter punishments on people who benefit from trafficking; creating and leading the Whiteclay Public Health Emergency Task Force that ultimately allowed the Oglala Sioux to reclaim sovereignty over their public health; legally protecting workers to discuss their wages without employer retaliation; codifying the Nebraska Department of Education’s definition of dyslexia as a learning disability, requiring schools to offer evidence-based reading support; and establishing Nebraska’s first officially recognized Indigenous People’s Day.

Patty was born and raised in Lincoln, Nebraska, where her family has lived for four generations. Two of her three children constitute the fifth generation in Lincoln. She is a proud product of Southeast High School, graduated from Colorado College with a B.A. in Political Science, and received her law degree at the University of Nebraska College of Law.

She lives with her husband Loel in Lincoln, where they work together as law partners. They are longtime members of First-Plymouth Congregational Church, where they were married (as were Patty’s parents Lu and Tom). Patty and Loel have three children, Taylor, Graham, and Avary, who have grown into bright, kind, and civic-minded young adults who fill their parents’ hearts with blessings and joy every day!

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