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On March 12, the U.S. Department of Health and Human Services (HHS) published a final rule on health insurance exchanges, which combines policies from two other proposed rules published last summer.

Health insurance exchanges are state-based marketplaces created under the Patient Protection and Affordable Care Act (PPACA) where individuals and small businesses will be able to purchase private health insurance. They are scheduled to be operational in 2014.

The March final rule combines two proposals: one published on July 15, 2011, that outlined a framework to enable states to build insurance exchanges and one that was published on Aug. 17, 2011, that outlined proposed standards for eligibility for enrollment in qualified health plans through the exchange and insurance affordability programs, including premium tax credits.

The final rule includes standards for:

  • The establishment and operation of an exchange
  • Health insurance plans that participate in an exchange
  • Determinations of an individual’s eligibility to enroll in exchange health plans and in insurance affordability programs
  • Enrollment in health plans through exchanges
  • Employer eligibility for and participation in the Small Business Health Options Program (SHOP)

Before the final rule was issued, HHS requested comments on both proposed rules (July 15 and Aug. 17) and received approximately 24,780 responses from the public, including several comment letters from ABC. Several provisions in the final rule, which are being issued as interim final, are open to further public comment. The rule officially will be published in the Federal Register on March 27.

Below are links to more information on ABC’s comments on exchanges and past proposed rules:

Oct. 31, 2011
Oct. 21, 2011
June 2011
October 2010