The Department of Health and Human Services March 12 issued a final rule implementing a key component of the Patient Protection and Affordable Care Act—creation of health insurance exchange markets in all states in 2014 through which millions of individuals and small businesses can buy coverage and receive premium assistance subsidies.
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The final rule combines two exchange rules proposed in 2011 under PPACA. An “establishment” proposed rule, published July 15, 2011, outlined a framework for states to build their exchanges. Another proposed rule, published Aug. 17, 2011, included standards for eligibility and enrollment in health plans, which must be certified as “qualified health plans” to be offered in the exchanges; as well as standards for tax credit premium and cost-sharing subsidies for low- and moderate-income individuals (29 HRR 880, 8/15/11).
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Although the final rule has a more immediate impact on individuals and small businesses, it also has implications for large employers, human resources and public policy experts told Bloomberg BNA.
“This matters to large employers in a less explicit manner, but it is important because states will have the option of opening their exchanges in 2017 to large employers,” Shawn Nowicki, director of public policy at HealthPass, told Bloomberg BNA March 15. HealthPass is a commercial, private health insurance exchange that works with small businesses in the New York area.
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According to Chiquita Brooks-LaSure, director of coverage policy in HHS's Office of Health Reform, the most significant change in the final rule from the proposed rule is that it allows additional flexibility for states regarding eligibility determinations. She said the final rule codified guidance issued by HHS in November 2011. More than 24,000 comments were filed on the proposed rule, Hill said.
Changes made to the proposed rule also allow states to determine a role for agents and brokers, including the use of online brokers, Hill said.
http://www.bna.com/hhs-issues-final-n12884908407/
Hat Tip: Bloomberg News BNA
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