The HIX Crucible

Individual health insurance exchanges are moving toward sustainability, but some payers and providers still fear the future.

This article first appeared in the October 2014 issue of HealthLeaders magazine.

What a difference a year makes.

Last fall, the new public health insurance exchanges seemed imperiled by the technical misadventures of the federal government's bug-plagued enrollment website, healthcare.gov, and some of the related state exchanges.

But as the second open enrollment period approaches next month, early doubt about whether the exchanges for individual coverage would survive the winter has given way to a view that an HIX future is certain. Insurance companies operating on the new exchanges are looking forward to a more predictable business environment; increased competition among carriers is easing patient and provider angst over narrow networks; the HIX marketplace has become a hotbed for innovation; and some on the exchanges are vying to upend the large group market that has dominated the health insurance industry for decades.