HHS Outlines Final Guidance for State Health Insurance Exchanges

The U.S. Department of Health and Human Services (HHS) has finalized its guidelines for states to develop their health insurance exchanges created by the Affordable Care Act (ACA) and set a Nov. 16 deadline for states to submit their plans.
by | August 14, 2012

The U.S. Department of Health and Human Services (HHS) has finalized its guidelines for states to develop their health insurance exchanges created under the Affordable Care Act (ACA) and set a Nov. 16 deadline for states to submit their plans.

As previously detailed, HHS is giving states three options: establishing a state-run exchange; participating in a partnership exchange (in which states would oversee plan management and/or customer service); or having a federal-run exchange.

States must submit two components in their application: a declaration letter (stating which exchange model a state plans to pursue) and then a complete exchange blueprint (due Nov. 16). Tuesday's guidance explained that states that submit a declaration letter more than 20 days before the November deadline can request a consultation with HHS to obtain further federal guidance on their exchange blueprint application.

HHS also outlined for the first time how states could transition from one exchange model to another in later years, an option that the department had previously indicated states could pursue. States wishing to alter their exchange model in 2015 would be asked to submit an exchange blueprint by Nov. 18, 2013; for 2016, applications would be due Nov. 18, 2014.

Also as previously stated, HHS said that states can receive conditional approval for their exchange, even if they do not meet all federal requirements, if they demonstrate significant progress toward having an operational exchange ready for Oct. 1, 2013, when exchanges are expected to start enrolling individuals.

HHS also reiterated that federal funding would be available through 2014 for states to develop and establish exchanges. Following the U.S. Supreme Court's decision to largely uphold the ACA, the department announced 10 new funding opportunities for exchange funding. So far, 34 states and the District of Columbia have received more than $850 million in exchange establishment grants.

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