Health Insurance Exchange Rules Highlight 'State Flexibility'

The Department of Health and Human Services today released many of the rules for health insurance exchanges, which include specifics about state functions and responsibilities.

Kaiser Health News has a copy of the health exchanges rule from the Federal Register, as well as the regulatory impact analysis.

The Associated Press: Feds Release Health Overhaul Blueprint For States
Tackling a huge logistical challenge, the Obama administration Monday released an ambitious blueprint for states to match up uninsured Americans with coverage that's right for them under the health care overhaul law. The long-awaited regulation, released as the Supreme Court prepares to hear a challenge to the law, stresses state and federal flexibility (Alonso-Zaldivar, 3/12).

Modern Healthcare: HHS Issues Final Rule On Health Insurance Exchanges
The final rule outlined the minimum standards states must meet in establishing and operating their exchanges, such as individual and employer eligibility for enrollment. The rule also outlines minimum standards that health insurers must meet to participate in an exchange and the standards employers must meet to participate in the exchange. The regulation aims to offer states "substantial discretion" in both the design and operation of their exchanges, according to the rule (Daly, 3/12).

Kaiser Health News:  Rules For New Insurance Marketplaces Give Insurers Clout
Insurers and other industry representatives will get to fill as many as half the seats on the governing boards for state health insurance exchanges, under final rules for the marketplaces issued today by the Department of Health and Human Services. At least one seat must be reserved for a consumer representative (Appleby, 3/12).

National Journal: HHS Releases Exchange Regulations
[HHS] laid out the [state's] functions: Certifying "qualified health plans"; operating a website for comparing plans; running a toll-free hot line for consumer support; providing grants to "Navigators" for consumer assistance; determining eligibility of consumers for enrollment in qualified health plans; and helping them enroll. States must build their insurance markets essentially from scratch and have been clamoring for the rules of the road before they invested heavily in infrastructure (Fox, 3/12). 

Politico Pro: Exchange Rule Keeps Disputed Provisions
Insurers, for example, wanted HHS to prevent exchanges from imposing requirements on plans in the exchanges beyond what is included in the health care reform law. States could use this power to create "active exchanges" that negotiate on behalf of consumers. ... But HHS disappointed consumer advocates by not reducing the number of insurers that will be allowed to sit on the board of the exchange. Up to half of a board can represent insurers under the new rules (Millman and Feder, 3/12).

The Hill: States Get 'Substantial Flexibility' In Running Health Law Exchanges
The final rules also offer each state more time to set up its exchange. The law requires states to "demonstrate complete readiness" by Jan. 1, 2013, in order to guarantee they'll be operational 12 months later. If states that don't meet the deadline, a federal exchange will take over (Pecquet, 3/12).

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