Health Exchange Regulations Forthcoming

July 13, 2011

This week, the U.S. Department of Health and Human Services (HHS) proposed a set of rules to govern the development of health insurance exchanges.  Starting in 2014, these exchanges will be available to small businesses and individuals to shop for health insurance, learn about tax credits and other premium assistance, and enroll in plans.

The 224-page proposal will be published in the Federal Register on July 15, followed by a 75-day public comment period.  Though NSBA will conduct a more extensive review and provide comments by the deadline, the HHS proposal appears to give broad discretion to states to design the health insurance exchanges.  For instance, states could partner to create regional exchanges, or maintain them within a state’s borders.  States also could choose to empower exchanges to be active purchasers (negotiators) or decide to restrict their role to the creation of an open marketplace.

States that choose to create their own exchanges must be certified as meeting the national standards by January 2013. If a state chooses not to create its own exchange, HHS will establish an exchange for that state. However the HHS rule is expected to provide for some leeway on this deadline.