• Joel S. Ario

    Managing Director
    Manatt Health
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    Direct: 518.431.6719
    General: 518.431.6700
    Fax: 518.431.6767

    New York
    Direct: 212.790.4588
    General: 212.790.4500
    Fax: 212.790.4545

    Direct: 202.585.6500
    General: 202.585.6500
    Fax: 202.585.6600


    Harvard Law School, J.D., cum laude, 1981.


    Harvard Divinity School, M.Div., cum laude, 1978.


    Saint Olaf College, B.A., American Political Experience, 1975.
    Phi Beta Kappa.

    • Profile
    • Representative Matters
    • Honors & Awards
    • Publications
    • Memberships & Activities
    • Speaking Engagements


    Joel Ario, a managing director at Manatt Health, has 30 years of experience helping to shape and implement public policy, including two decades devoted to leading health insurance reform efforts at the state and federal government levels. He provides strategic consulting and policy analysis to assist state governments, health plans, hospitals, foundations, and other stakeholders in understanding and navigating the health reform landscape, with a particular emphasis on the role of public and private exchange-based marketplaces.

    Mr. Ario previously served as Director of the Office of Health Insurance Exchanges at the U.S. Department of Health & Human Services (HHS), where he worked closely with states and other stakeholders in leading HHS efforts to develop the regulatory framework for exchanges, including the rights and responsibilities of states and the federal government in expanding coverage, overseeing the insurance marketplace, and safeguarding consumer rights.

    Prior to his federal service, Mr. Ario was Pennsylvania Insurance Commissioner from 2007 to 2010 and Oregon Insurance Commissioner from 2000 to 2007. Mr. Ario served on the Executive Committee of the National Association of Insurance Commissioners (NAIC) for a decade and was an NAIC officer from 2003 to 2005.

    Mr. Ario serves as an advisor to the Robert Wood Johnson Foundation in support of its State Health Reform Assistance Network, and is a member of the Leavitt Partners Future Panel. His publications include “Post Election, the Affordable Care Act Leaves the Intensive Care Unit for Good” (with Larry Jacobs, Health Affairs Entry Point, Dec. 2012) and “Public Exchanges Dominate the Headlines, but Will Private Exchanges Really Shape the Future?” (Manatt Health Update Newsletter, June 2013).

    Representative Matters

    Honors & Awards

    CMS Award of Excellence, Center for Medicaid and Children’s Services, September 2011.

    Excellence in Consumer Advocacy Award, National Association of Insurance Commissioners (NAIC) Consumer Representatives, October 2010.

    Neil D. Levin Memorial Government Service Award, Israel Bonds, October 2009.


    Co-author, “Building on Year One 1095-A Form Success: Marketplaces’ Recommendations for Future Tax Seasons,” the State Health Reform Assistance Network, a program of the Robert Wood Johnson Foundation, September 2015.

    Co-author, “How Mobile Apps will Empower Health Care Consumers,” Brookings, April 20, 2015.

    Co-author, “Innovation Waivers: An Opportunity for States to Pursue Their Own Brand of Health Reform,” The Commonwealth Fund and the Robert Wood Johnson Foundation State Health Reform Assistance Network, April 2015.

    “King v. Burwell: What a Subsidy Shutdown Could Mean for…Consumers, Insurers, Health Care Providers and States,” Series of four articles prepared for The Commonwealth Fund blog, February 24-27, 2015.

    Co-author, “Reference Pricing And Network Adequacy Standards: Conflict Or Concord?” Health Affairs, September 18, 2014.

    Co-author, “Understanding the Potential Role Web Brokers Can Play in State-Based Marketplaces,” Robert Wood Johnson Foundation’s State Health Reform Assistance Network, June 2014.

    Co-author, “Premium Rate Variation In Exchanges Is An Eye Opener,” Health Affairs, August 7, 2013.

    “Public Exchanges Dominate the Headlines, but Will Private Exchanges Really Shape the Future?” Manatt Health Update, June 24, 2013.

    Co-author, “Post Election, The Affordable Care Act Leaves The Intensive Care Unit For Good,” Health Affairs, December 2012.

    Co-author, “In the Wake of the Supreme Court Decision, Many Stakeholders Still Support the Affordable Care Act,” Health Affairs, August 2012.

    Co-author, “Health Reform - Genie is Out of the Bottle,” The Hill, April 2012.

    Memberships & Activities

    Speaking Engagements

    “Provider Payment Reform in NH: Legal Considerations for Policymakers,” New Hampshire Insurance Department (NHID), Health Care Payment Reform Forum, Concord, NH, April 24, 2015.

    “What States Could Do with 1332 Innovation Waivers,” Maximus Forum, Washington, D.C., February 6, 2015.

    “ACA Implementation is on Track,” National Association for Social Insurance Forum, Washington, DC, January 28, 2015.

    “Looking Ahead on the ACA: Predictions for 2015,” Bloomberg BNA Forum, Washington, D.C., January 14, 2015.

    “State and Federal Enforcement of the ACA,” American Medical Association (AMA) State Legislative Strategy Conference, New Orleans, LA, January 10, 2015.

    “Consumer Experience in the Exchange Marketplaces,” New York Bar Association Forum, New York, NY, January 9, 2015.

    “Thinking Ahead: 1332 State Innovation Waivers,” Robert Wood Johnson Foundation State Health Reform Assistance Network Webinar, December 4, 2014.

    “Navigating the Emerging Exchange Marketplace,” Manatt Webinar, November 19, 2014.

    “Narrow Networks, High Cost Sharing and other Market Disrupters,” Novartis Webinar, November 18, 2014.

    “What to Expect in the 2015 Enrollment Period,” Humphrey Institute Forum, Minneapolis, MN, November 14, 2014.

    “What the 2014 Election Results Mean for the Affordable Care Act,” Manatt Forum, San Francisco, CA, November 11, 2014.

    “Marketplace and Medicaid Convergence,” Society of Actuaries Annual Meeting, Orlando, FL, October 29, 2014.

    “Trends in ACA Implementation,” University of Pittsburgh Medical Center (UPMC) Health Plan Conclave, Nemacolin, PA, October 17, 2014.

    “Politics and the Affordable Care Act,” Morgan Stanley Forum, New York, NY, October 6, 2014.

    “State Exchange Financing and Sustainability,” Robert Wood Johnson Foundation State Health Reform Assistance Network Forum, October 2, 2014.

    “The Future of Public and Private Exchanges,” LIMRA Worksite Benefits Conference, Baltimore, MD, September 5, 2014.

    “Network Adequacy and Competition in the Exchanges,” Alliance for Health Reform Briefing, Washington, D.C., August 6, 2014.

    “Consumers, Providers and Exchanges,” Hamot Board Retreat, Peek n’ Peak, NY, July 21, 2014.

    “Medicaid Plans and the Marketplaces,” Association for Community Affiliated Plans CEO Summit, Washington, D.C., June 25, 2014.

    “What’s Next with the State and Federal Exchanges,” Blue Cross Blue Shield Association (BCBSA) Forum, Washington, D.C., June 16, 2014.

    “Opportunities for State-based Marketplaces,” Your Health Idaho Board Meeting, Boise, ID, May 21, 2014.

    “Improving the Consumer Experience” and “Medicaid-Marketplace Convergence,” Second Annual National Health Insurance Exchange Summit, Washington, D.C., May 14-16, 2014.

    “Emerging Exchange Marketplace,” Lifetime Health Companies Board Retreat, Syracuse, NY, May 15, 2014.

    “Emerging Exchange Marketplace,” Children’s Hospital Association, Atlanta, GA, May 12, 2014.

    “Ancillary Benefits in the Exchange Marketplaces,” 2014 Specialty Health Summit, Nashville, TN, May 6, 2014.

    “ACA Implementation from the National Perspective,” California Society for Health Attorneys Annual Conference, Lake Tahoe, CA, April 12, 2014.

    “Challenges Facing the ACA,” New York Bar Association Forum, New York, NY, April 11, 2014.

    “Post Mortem on the First Open Enrollment Period,” UPenn Second Annual Health Insurance Exchanges Conference, Philadelphia, PA, April 10, 2014.

    “Essential Health Benefits and the Marketplaces,” Delta Dental Forum, Washington, D.C., April 8, 2014.

    “Web Brokers and Private Exchanges,” Health Care Reform Regulatory Alternatives Working Group, National Association of Insurance Commissioners (NAIC) Spring Meeting, Orlando, FL, March 31, 2014.

    “The ACA’s Coverage Reforms and Mandates,” Bloomberg BNA Webinar, March 27, 2014.

    “Does the ACA Need Tweaking,” Commonwealth Congressional Retreat, Houston, TX, March 1, 2014.

    “Assessing the First Open Enrollment Period,” Humphrey Institute, Minneapolis, MN, February 14, 2014.

    “Exchange Implementation: Cooperative Federalism in Action,” Yale Health Law Policy Conference, New Haven, CT, February 8, 2014.

    “Marketplace-Medicaid Convergence,” Academy Health’s National Health Policy Conference, Washington, D.C., February 4, 2014.

    “Pitfalls Ahead for the ACA,” National Press Club, Washington, DC, February 3, 2014.

    “Looking Ahead on the ACA: Predictions for 2014,” Bloomberg BNA Forum, Washington, D.C., January 16, 2015.

    “Medicaid and Exchange Coverages,” American Hospital Association State Issues Forum, Washington, D.C., January 16, 2014.

    “Engaging Consumers in the ACA,” University of Chicago Forum, Chicago, IL, January 10, 2014.

    “The Tortured Path to an Exchange Marketplace,” Bank of America Merrill Lynch, Boca Raton, FL, December 4, 2013.

    “Strategies for Advancing Health Reform,” Oregon Health Policy Board, Hood River, OR, November 5, 2013.

    “ACOs and Exchanges” and “The ABCs of the ACA,” First National Health Insurance Exchange Summit West, November 4, 2013.

    “Crunch Time for the ACA,” Leavitt Partners Fall Summit, Salt Lake City, UT, October 22, 2013.

    “Consumer Strategies with Essential Health Benefits,” PhRMA State Advocacy National Leadership Meeting, Washington, D.C., October 17, 2013.

    “Understanding the Affordable Care Act,” Manatt Webinar, October 16, 2013.

    “Emerging Exchange Marketplace,” St. Louis Hospital Association, St. Louis, MO, October 8, 2013.

    “Challenges Facing the Exchanges,” Drake University Forum, October 7, 2013.

    “Emerging Exchange Marketplaces,” Inovalon Customer Congress, Jacksonville, FL, October 1, 2013.

    “What to Expect from Exchanges,” Bloomberg BNA Webinar, September 19, 2013.

    “Exchanges and Providers,” American Hospital Association Leadership Summit, Los Angeles, CA, September 11, 2013.

    “Aligning Oregon Health Policy Reform with the ACA,” Oregon Health Policy Board, Portland, OR, August 6, 2013.

    “Emerging Exchange Marketplaces,” World Congress on Health Reform, Alexandria, VA, July 16, 2013.

    “Emerging Exchange Marketplaces,” Children’s Hospital Association, New York, NY, May 9, 2013.

    “How will the Federal Exchange Work” and “The Future of Exchanges,” National Health Insurance Exchange Summit, Washington, DC, May 1-3, 2013.

    “Building Toward Exchanges,” Planned Parenthood Conference, Washington, D.C., April 23, 2013.

    “Emerging Exchange Marketplace,” UPenn Health Insurance Exchanges Conference, Philadelphia, PA, April 12, 2013.

    “Expanding Coverage,” Ascension Health, Amsterdam, NY, March 28, 2013.

    “Public and Private Exchanges,” Morgan Stanley Forum, New York, NY, March 27, 2013.

    “Emerging Exchange Marketplaces,” Western Michigan Association of Health Underwriters, Grand Rapids, MI, March 21, 2013.

    “Provider-based Insurers and Exchanges,” Alliance of Community Health Plans Annual Conference, Austin, TX, March 18, 2013.

    “Assessing the Exchange Landscape,” Leavitt Partners Roundtable, Washington, D.C., March 9, 2013.

    “The Private Option and State Exchanges,” Arkansas Legislature, March 4, 2013.

    “Employer Responsibility for Healthcare,” Manatt Webinar, February 28, 2013.

    “Taking Stock on Exchanges,” Citi’s 2013 Global Healthcare Conference, New York, NY, February 25, 2013.

    “Next Steps in Health Reform,” Hershey Rotary, Hershey, PA, February 4, 2013.

    “Exchanges and Essential Health Benefits,” CBI Bio-Pharmaceutical Conference, Philadelphia, PA, January 31, 2013.

    “Operationalizing Enforcement of the ACA Market Reforms,” Robert Wood Johnson Foundation State Health Reform Assistance Network Webinar, January 28, 2013.

    “State Exchange Legislation,” Humphrey Institute Legislator Training Session, January 9, 2013.

    “QHP Contracting,” Maryland Health Benefit Exchange Forum, Baltimore, MD, December 19, 2012.

    “The Case for State Exchanges,” Health Care Reform Symposium, Jackson, MS, December 13, 2012.

    “Next Steps in Health Reform,” Pennsylvania Hospital Association Annual Meeting, October 19, 2012.

    “The Virtues of the ACA,” Lehigh Valley Chamber of Commerce, Bethlehem, PA, October 18, 2012.

    “Planning for an Uncertain Future,” Leavitt Partners Full Summit, Salt Lake City, UT, October 16, 2012.

    “Blueprint Guidelines for Partnership Exchanges,” National Academy for State Health Policy (NASHP) Forum, Baltimore, MD, October 15, 2012.

    “Federal and State Health Policy Initiatives,” URAC Annual Conference, San Francisco, CA, October 10, 2012.

    “Navigating Rate Regulation under the ACA,” 2012 Blue National Summit, Orlando, FL, September 10, 2012.

    “Consequences for the Insurance Industry,” Bipartisan Policy Center Forum on the Supreme Court’s ACA Decision, Washington, D.C., July 31, 2012.

    “Policy Choices in Developing a SHOP,” Virginia Health Reform Advisory Council, Richmond, VA, June 13, 2012.

    “Potential Outcomes in the Supreme Court,” California Health Foundation Webinar, May 6, 2012.

    “ACA Architecture and the Supreme Court,” California Society for Health Attorneys Annual Conference, Monterey, CA, April 21, 2012.

    “Where are Exchanges Headed,” American Association of Preferred Provider Organizations Capitol Caucus Forum, Washington, D.C., March 27, 2012.

    “What Do Insurers Do with EHBs,” American Health Law Association Webinar, March 26, 2012.

    “The Case for the ACA,” Humphrey Institute, Minneapolis, MN, March 13, 2012.

    “What Does the HHS Policy on EHBs Mean for States,” American Cancer Society Forum, Washington, D.C., February 28, 2012.

    “Exchanges and Essential Health Benefits,” Bipartisan Policy Center Webinar, February 16, 2012.

    “Planning for a North Carolina Exchange,” North Carolina Exchange Task Force Webinar, February 16, 2012.

    “Progress Report on Exchanges,” Arizona Hospital Association Webinar, February 14, 2012.

    “Federal Exchange Scenarios,” Leavitt Partners Forum, Salt Lake City, UT, February 8, 2012.

    “Progress on Exchanges,” National Association for Social Insurance Forum, Washington, D.C., January 26, 2012.

    “State of the States: Health Insurance Exchanges in Various States,” Health Insurance Exchange Congress, Baltimore, MD, November 9-11, 2011.

    “Progress Report on State Exchanges,” Blue Cross Blue Shield Association (BCBSA) Forum, San Francisco, CA, November 2011.

    “Exchanges Put the Consumer in Charge,” National Patient Advocacy Foundation Conference, Washington, D.C., November 2011.

    “Exchanges as the Lynchpin of Health Reform,” Harvard Law School Forum, Cambridge, MA, November 2011.

    “Overview of Exchange Regulations,” U.S. Department of Health and Human Services (HHS) listening sessions in Portland, OR, Denver, CO, and Atlanta, GA, August and September 2011.

    “Next Steps for State Exchanges,” National Conference of State Legislators (NCSL), San Antonio, TX, August 2011.

    “Exchanges and Health Care Quality,” Engleberg Center for Health Care Reform, Brookings Institution, Washington, D.C., July 2011.

    “Federal-State Partnerships on Exchanges,” California Exchange Board Meeting, Sacramento, CA, June 2011.

    “Federal Perspective on Launching Insurance Exchanges,” AARP Solutions Forum, Capitol Hill, April 2011.

    “Emerging Framework for Exchanges,” American Hospital Association (AHA) Forum, Washington, D.C., March 2011.

    “The Role of Agents in Exchanges,” National Association of Health Underwriters (NAHU) Annual Capitol Conference, Washington, D.C., February 2011.

    “Exchange Developments,” Bipartisan Policy Center Retreat, Capitol Hill, February 2011.

    “Streamlining Eligibility and Enrollment,” National Association of State Health Policy (NASHP), Washington, D.C., January 2011.

    “Exchange Options for Iowa,” State of Iowa Information Center, Des Moines, IA, December 2010.

    “Overview of Health Insurance Exchanges,” America’s Health Insurance Plans (AHIP) Conference, Chicago, IL, November 2010.

    “Regulatory Challenges for State-based Exchanges,” National Association of Insurance Commissioners (NAIC) National Meeting, Orlando, FL, October 2010.

    “State Role with Exchanges,” National Governors Association (NGA) health reform implementation meetings for state officials in Stowe, VT, and Seattle, WA, September 2010.