HHS Releases Final Blueprint for State-based Exchanges under the Affordable Care Act
On August 14, 2012, the Department of Health and Human Services’ (“HHS”) Center for Consumer Information and Insurance Oversight released the final Blueprint for approval of State-based and State Partnership Insurance Exchanges (“Blueprint”). The Affordable Care Act (“ACA”) established the Exchanges, which will become operational in January 2014, and 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. The ACA provides that states can choose to operate as a State-based Exchange, or for those states that do not choose to operate a State-based exchange, HHS will establish and operate a Federally-facilitated Exchange. In a Federally-facilitated Exchange, a state can elect to participate in a State Partnership Exchange, where the state will administer and operate Exchange functions associated with plan management, consumer assistance, or both.
For a state to operate a State-based Exchange in 2014, HHS must approve or conditionally approve State-based Exchanges no later than January 1, 2013.
A state must complete and submit an Exchange Blueprint in order to receive approval or conditional approval from HHS for either a State-based Exchange or a State Partnership Exchange. The Exchange Blueprint consists of two components: (1) Declaration Letter and (2) Exchange Application, and must be submitted on or before November 16, 2012, to receive HHS approval or conditional approval before January 1, 2013, with an operational beginning date of January 2014. The Blueprint issued by HHS provides states with guidance on completing their Declaration Letter and Exchange Application.
At this point, the ACA and implementing regulations do not allow for the participation of multiemployer health and welfare plans in the Exchanges.
For more information about Exchanges and the Affordable Care Act, please contact your Trust Fund counsel.
Author: Ezekiel D. Carder
