HHS Issues Proposed Regulations On Insurance Exchanges Under Reform Law

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The Obama administration July 11 issued two proposed regulations to aid in the creation of state health insurance marketplaces under the Patient Protection and Affordable Care Act.

One proposal (docket CMS-9989-P) would establish health insurance exchanges, with the goal of providing competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors.

The exchanges, which are to be operational by Jan. 1, 2014, will help enhance competition in the health insurance market, improve choice of affordable health insurance, and give small businesses the same purchasing clout as large businesses, according to the proposal from the Department of Health and Human Services.

The second proposed rule (CMS-9975-P) pertains to standards for reinsurance, risk corridors, and risk adjustment. HHS said these programs will mitigate the impact of potential adverse selection and will stabilize premiums in the individual and small group markets as insurance reforms and the insurance exchanges are implemented, starting in 2014.

Exchanges Will Make It Easier to Compare Plans

In a press release, HHS said the proposals will help states build their Affordable Insurance Exchanges, which are “state-based competitive marketplaces where individuals and small businesses will be able to purchase affordable private health insurance and have the same insurance choices as members of Congress.”

Starting in 2014, the exchanges “will make it easy for individuals and small businesses to compare health plans, get answers to questions, find out if they are eligible for tax credits for private insurance or health programs like the Children's Health Insurance Program (CHIP), and enroll in a health plan that meets their needs,” the release said.

Both proposed rules are set for publication in the July 15 Federal Register. Comments on both proposals are due 75 days after publication of the regulations.

Text of the proposal on exchanges is at http://op.bna.com/hl.nsf/r?Open=mapi-8jnlaf .

Text of the proposal on reinsurance and risk corridors, is at http://op.bna.com/hl.nsf/r?Open=droy-8jnl73 .

Fact sheets on the rules are at http://www.healthcare.gov/law/provisions/exchanges/index.html .