The Denver Post has quoted Colo. state rep Amy Stephens as saying that “Most people viewed exchanges as the most free-market part of Obamacare.”  As I’ve noted before, this is wrong. The most, and only free-market part ObamaCare [HR 3590] is the removal of restrictions on how insurers can discount premiums through wellness programs.

But viewing state-run exchanges as somehow free-market is also wrong because, from what I can tell, privately-run exchanges already exist.  Or something very close to them. Why should government put them out of business by competing with them?  Consider the following, which I think are Multiple Employer Welfare Arrangements (ref).

1. New York City: Health Pass.  “A New York City-based non-profit insurance exchange, one of the few in the nation, is celebrating its 10th anniversary, saying it now provides health insurance to more than 3,500 small businesses and nonprofit organizations in metropolitan New York.” Insurance & Financial Advisor, June 2009.

2. Connecticut Business and Industry Association (CBIA) Health Connections: A Robert Wood Johnson Foundation report on exchanges profiles this one.

3. California: Choice Administrators.  “California’s Anthem Blue Cross, Health Net, Kaiser Permanente, Sharp Health Plan, Western Health Advantage, and numerous leading dental, vision, chiropractic and related ancillary benefit plans all employ CHOICE Administrator’s flagship products, CaliforniaChoice, an exchange for the small and mid-sized employer market.” – Health Care Finance News, June 2010.

There’s also  Trinet Human Resources Outsourcing, a Professional Employer Organization. It differs from an exchange, but but may offer similar functions, such as many health plans for employees of small companies. See this article about TriNet & PEOs in the San Jose Business Journal.

For each of the above, I don’t know how portable the plans are. That is, if you change jobs from one Trinet customer (employer) to another, whether you keep the same policy. But I’d expect that you could.