Maryland lawmakers approved legislation Thursday establishing the Maryland Health Benefits Exchange, an online insurance marketplace outlined in the Affordable Care Act (ACA).

The legislation, which will be sent to Gov. Martin O'Malley, who is expected to sign it, authorizes the exchange to contract with health insurance providers to place their plans on the exchange starting in 2014. Lawmakers set parameters for what providers can participate in the exchange.

The bill also outlines "navigator" programs for the small business and individual markets, outreach efforts that will ensure the exchange's customers understand how to utilize the exchange.

It authorizes the Maryland Health Care Reform Coordinating Council, created by O'Malley and co-chaired by Lt. Gov. Anthony Brown, to establish an essential health benefits package (detailing the minimum amount of coverage for plans sold on the exchange) through "an open, transparent and inclusive process," the bill summary states.

O'Malley's proposed fiscal year 2013 budget sets aside $26.3 million for the exchange, according to the bill summary, almost all of which will come from federal establishment grants.

The state legislature passed a bill last year that established the exchange's governing board (seated by members of Malley's administration and his appointees) and a loose framework for the marketplace. According to Brown's office, the board then consulted with stakeholders and experts to develop the model that was approved by the legislature this week.

According to the National Conference of State Legislatures, 12 states (including Utah and Massachusetts, which had exchanges prior to the ACA) plus the District of Columbia have enacted exchange legislation. Rhode Island Gov. Lincoln Chafee also established an exchange through an executive order. Another 21 states have exchange legislation pending in their statehouses.

Below is the official fiscal and policy summary of Maryland's exchange act.

  Maryland Health Benefit Exchange Summary (PDF)
Maryland Health Benefit Exchange Summary (Text)

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