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Critical Condition

NRO’s health-care blog.

One Way Massachusetts’ Commonwealth Connector Beats Utah’s Health Exchange



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The range of current libertarian-conservative expert opinion on Obamacare’s Health Benefits Exchanges has well-defined boundaries. On one hand, there are those who believe that states are obliged to establish some sort of bare-bones exchange along the lines of the Utah Health Exchange in order to prevent the federal government from coming into a state and imposing a bloated contraption like Massachusetts’ Commonwealth Connector. (For an example of this approach, see here.) Others (including myself) believe that the Utah Health Exchange is unimpressive, that no “exchange” can overcome certain bureaucratic necessities, and that states should therefore refuse to collaborate with Obamacare while waiting for it to be overturned by the Supreme Court or a future Congress and president. (The Cato Institute’s Michael Cannon has also arrived at this conclusion.)

None of us has had anything positive to say about Massachusetts’ Commonwealth Connector — until now! In one respect, the Commonwealth Connector is an extremely well-run government program and the Utah Health Exchange is not: The issue is transparency.

Soon after I started writing critically about the Utah Health Exchange, I received e-mails and phone calls from a businessperson with a financial interest in the success of that enterprise, scolding me for using out-of-date information. The new Utah Health Exchange, re-launched in 2011, is going gangbusters, according to a phone conversation that this businessperson had recently held with the exchange’s boss.

Sorry, not good enough. The Utah Health Exchange has never published an annual report, and its last press release was dated April 28, 2010! Massachusetts’s Commonwealth Connector, on the other hand, published a thorough report on the effect of the mandate last December, and its mandated annual report to the legislature the month before that. It also publishes its schedule of board meetings, including the agenda of each meeting and the minutes of previous meetings.

The Bay State’s Commonwealth Connector is an expensive and unnecessary bureaucracy, but at least it’s upfront about what it’s doing. Even its critics should congratulate its transparency. Advocates of the Utah Health Exchange, on the other hand, evangelize from a data-free zone of wishful thinking. Those who believe that Utah has shown how to run a health-benefits exchange should demand that the state provide data to support such a conclusion.



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