HHS Issues Proposal on Health Insurance Exchanges

July 11, 2011 (PLANSPONSOR.com) - The U.S. Department of Health and Human Services (HHS) has proposed a framework to assist states in building insurance exchanges, which will be available in 2014 under the Patient Protection and Affordable Care Act.

 HHS proposed new rules offering states guidance and options on how to structure their 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, and 
  • Ensuring premium stability for plans and enrollees in the Exchange, especially in the early years as new people come in to Exchanges to shop for health insurance. 


According to an HHS news release, the proposed rules set minimum standards for Exchanges, give states the flexibility they need to design Exchanges that best fit their unique insurance markets, and are consistent with steps states have already taken to move forward with Exchanges. They allow states to decide whether their Exchanges should be local, regional, or operated by a non-profit organization, how to select plans to participate, and whether to partner with HHS to split up the work.  

Forty-nine states, the District of Columbia and four territories accepted grants to help plan and operate Exchanges, the announcement said. In addition, over half of all states are taking additional action beyond receiving a planning grant such as passing legislation or taking Administrative action to begin building exchanges. States will continue to implement exchanges on different schedules through 2014.  

HHS is accepting public comment on the proposed rules over the next 75 days.  

The proposed rules are scheduled for publication in the July 15 Federal Register  

More information about the insurance exchanges is at http://www.healthcare.gov/law/provisions/exchanges/index.html.