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The Department of Health and Human Services (HHS) July 15 issued a proposed rule related to the implementation of the health care exchange provision in the Patient Protection and Affordable Care Act (PPACA). Under PPACA, by Jan. 1, 2014, individuals and small businesses will be able to purchase private health insurance through state-based competitive marketplaces, called Health Insurance Exchanges.

In the proposed rules, HHS does the following:

sets forth federal requirements that states must meet if they elect to establish and operate an exchange;
outlines the minimum requirements that health insurance issuers must meet to participate in an exchange and offer qualified health plans; and
provides basic standards that employers must meet to participate in the Small Business Health Options Program.

ABC submitted comments on exchanges during the first comment period in October 2010 and then again in June 2011. The comments included suggestions on how to ensure stability for plans and enrollees, in addition to pointing out the need for a responsive and sustainable exchange that attracts and caters to small businesses, their employees and families who need access to more plans, greater transparency and affordable options.  

These rules do not address all of the exchange provisions in PPACA and additional guidance on the establishment and operation of exchanges will be provided in future proposed rules. 

HHS is accepting comments on this rule until Sept. 28. To submit a comment, visit

For more information visit the HHS website.