HIEs: Still More Questions than Answers

So the question remains: what will an insurance exchange look like in my state? About the only thing we can count on is that HIEs will likely have a different flavor depending on where you live. In fact, it often will reflect the view of the state's controlling party, according to Bill Copeland, national managing director for professional services giant Deloitte.

"The kind of exchange you'll see in a Democratic state versus a Republican state is probably going to be different," he says, with Republican states favoring market-driven, competition-based solutions and Democratic states leaning toward a more regulated environment.

One thing we know for certain, according to Copeland, is that exchanges will be a competitive distribution insurance market. "Whether it's small group or individual, it's will very much be a retail marketplace," he said. He reminds health plans that this is not a new form of distribution, just a new business model, which will likely spur product innovation among health plans.