Thursday, March 15, 2012

The Status of Health Care Exchanges: HHS Issues Final Rule

On February 28 at the HealthWatch Wisconsin Annual Conference, Senator Kathleen Vinehout (pictured at right) described her vision of a health care exchange for our state, following SB 273, legislation she introduced to provide a competitive health insurance market to Wisconsin's small businesses and individuals. However, the current Administration returned the planning and "Early Innovator" funding to Washington, the money specifically intended for the development of Wisconsin's health exchange. And the timing could not have been worse.
Already, a majority of states have taken significant steps to build exchanges. HHS announced recently that 33 states and the District of Columbia have received over $667 million in Establishment Grants to begin building their exchanges.
On March 12, the U.S. Department of Health and Human Services (HHS) announced policies to help states build insurance exchanges. Printed as "final rules" in the Federal Register, HHS outlined the design requirements for the insurance exchanges due to launch January 1, 2014. The rule sets minimum standards states must meet, such as eligibility for individuals and employers, and the minimum standards insurance companies need to meet to participate in an exchange. Finally, the rule sets standards for employers. Last year, HHS issued two separate "proposed regulations" that generated a lot of feedback. HHS included "more flexibility for states" than envisioned in those earlier drafts, mostly for states to determine eligibility requirements for their exchanges. The new rule also presents details on the role of agents and brokers in the exchanges, while protecting the privacy of enrollee data. “These policies give states the flexibility they need to design an exchange that works for them,” said HHS Secretary Kathleen Sebelius.

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