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HHS Releases Insurance Exchange Rule

March 12, 2012
by Gabriel Perna
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Health and Human Services (HHS) Secretary Kathleen Sebelius has announced the final rule of its policies to assist statesin building Affordable Insurance Exchanges. The exchanges will be designed as a one-stop marketplace, which will allow consumers and small businesses to choose a private health insurance plan while offering people the same kinds of insurance choices as members of Congress.

The recently released rule will help states in designing their Exchanges for their own citizens’ needs. The policy is set to begin in 2014.

“These policies give States the flexibility they need to design an Exchange that works for them,” Sebelius said in a statement. “These new marketplaces will offer Americans one-stop shopping for health insurance, where insurers will compete for your business. More competition will drive down costs and Exchanges will give individuals and small businesses the same purchasing power big businesses have today.”

The policies attempt offer guidance about the options on how to structure Exchanges in two key areas: setting standards for establishing Exchanges, setting up a Small Business Health Options Program (SHOP), performing the basic functions of an Exchange, and certifying health plans for participation in the Exchange as well as, establishing a streamlined, web-based system for consumers to apply for and enroll in qualified health plans and insurance affordability programs.

The final rule attempts to build on the flexibility and resources provided by HHS already to build State-based Exchanges. A majority of States have taken significant steps in building Exchanges. Previously, HHS awarded 49 States and the District of Columbia $50 million to begin planning their Exchanges, and as announced recently, 33 States and the District of Columbia have received over $667 million in Establishment Grants to begin building their Exchanges. 

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