HHS releases exchange rules, highlights 'state flexibility'

The Department of Health and Human Services today released the final rule for health insurance exchanges, which reportedly includes specifics about state functions and responsibilities.

Kaiser Health News has a copy of the health exchanges rule from the Federal Register, as well as the regulatory impact analysis.

The Associated Press: Feds Release Health Overhaul Blueprint For States
Tackling a huge logistical challenge, the Obama administration Monday released an ambitious blueprint for states to match up uninsured Americans with coverage that's right for them under the health care overhaul law. The long-awaited regulation, released as the Supreme Court prepares to hear a challenge to the law, stresses state and federal flexibility (Alonso-Zaldivar, 3/12).

National Journal: HHS Releases Exchange Regulations
HHS said states will have "substantial flexibility" in operating the exchanges and laid out their functions: Certifying "qualified health plans"; operating a website for comparing plans; running a toll-free hot line for consumer support; providing grants to "Navigators" for consumer assistance; determining eligibility of consumers for enrollment in qualified health plans; and helping them enroll. States must build their insurance markets essentially from scratch and have been clamoring for the rules of the road before they invested heavily in infrastructure. The department issued an interim final rule this summer, but many questions have remained (Fox, 3/12). 

Modern Healthcare: HHS Issues Final Rule On Health Insurance Exchanges
The final rule outlined the minimum standards states must meet in establishing and operating their exchanges, such as individual and employer eligibility for enrollment. The rule also outlines minimum standards that health insurers must meet to participate in an exchange and the standards employers must meet to participate in the exchange. The regulation aims to offer states "substantial discretion" in both the design and operation of their exchanges, according to the rule (Daly, 3/12).

The Hill: States Get 'Substantial Flexility' In Running Health Law Exchanges
The final rules also offer each state more time to set up its exchange. The law requires states to "demonstrate complete readiness" by Jan. 1, 2013, in order to guarantee they'll be operational 12 months later. If states that don't meet the deadline, a federal exchange will take over (Pecquet, 3/12).