HHS: We Made Exchanges Easier for States

The U.S. Department of Health & Human Services (HHS) released March 12 a final rule outlining Affordable Health Insurance Exchanges (Exchanges) and their operation. The rule reflects an easier process of implementation than expected by states when health care reform laws were signed in 2010.

Starting in 2014, one-stop marketplaces called Exchanges will enable consumers and small businesses to choose a quality, affordable private health insurance plan that fits their health needs, HHS said. Exchanges will offer health insurance options for meeting consumer-friendly standards; facilitating consumer assistance, shopping for and enrollment in a private health insurance plan; and coordinating eligibility for premium tax credits and other affordability programs that ensure health insurance is affordable for all Americans. Through Exchanges, the public will have the same kinds of insurance choices as members of Congress, a statement from HHS said.

HHS maintains, “Exchanges will offer Americans competition, choice, and clout. Insurance companies will compete for business on a level playing field, driving down costs.”

The final rule offers a framework to assist states in setting up Exchanges. The framework preserves and, in some cases, expands the significant flexibility in the proposed rules that enables states to build an Exchange that works for their residents. For example, the final rule allows states to decide whether their Exchange should be operated by a non-profit organization or a public agency, how to select plans to participate, and whether to partner with HHS for some key functions. The final rule also offers significant additional flexibility regarding the eligibility determination process. It also makes it easier for small businesses to get coverage through the Small Business Health Options Program (SHOP), strengthens consumer protections, and keeps it simple for health plans interested in participating in Exchanges.

More information is available on the HHS web page.

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