On March 12, HHS released a final rule (CMS-9989-F) establishing guidelines for states to set up the “Affordable Insurance Exchanges” mandated by PPACA. The rule states that the exchanges, scheduled to become operational on January 1, 2014, will provide “competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors.”
In its fact sheet on the rule, HHS said that it will give the public “the same kinds of insurance choices as members of Congress.” The rule gives each state significant flexibility to build an exchange to benefit its residents, including whether it should be operated by a non-profit organization or a public agency, how participating plans will be chosen, and whether to partner with HHS for administrative functions. The rule also gives states flexibility regarding the eligibility determination process. HHS estimates that it will make grants to states to be used for the exchanges in the total amount of $3.4 billion over the next four years.
The final rule incorporates provisions originally published in two proposed rules last summer. Certain provisions of the final rule will be issued as “interim final,” with public comments to be accepted until May 11.