Obama administration releases rules for health exchanges, emphasizes flexibility for states

The regulations outline minimum standards that states must meet to set up and run these health insurance marketplaces by a Jan. 1, 2014, deadline. 

Kaiser Health News: Rules For New Insurance Marketplaces Give Insurers Clout
Insurers and other industry representatives will get to fill as many as half the seats on the governing boards for state health insurance exchanges, under final rules for the marketplaces issued today by the Department of Health and Human Services.  At least one seat must be reserved for a consumer representative. The long-awaited rules are likely to disappoint consumer advocates who would have preferred the governing boards "be dominated by consumers," said Timothy Jost, who speaks as a consumer advocate before the National Association of Insurance Commissioners and is a professor at the Washington and Lee University School of Law (Appleby, 3/12).

NewsHour: New Health Reform Rules Issued As Supreme Court Review Nears
The much-anticipated final regulations for health insurance exchanges -- released Monday in a 644-page document -- emphasized the broad latitude states will have in developing and implementing their own health insurance marketplaces by 2014. The virtual shopping centers will aim to make the process of buying health insurance as easy as navigating a site like Amazon.com and are expected to serve about 21 million Americans by 2017. According to Health and Human Services Secretary Kathleen Sebelius, the final exchange regulations give states "the flexibility they need to design an exchange that works for them." She also reiterated the administration's belief that the exchanges will boost competition in the individual and small-business marketplace and will give both groups "the same purchasing power big businesses have today" (Kane, 3/12).

The Associated Press/Washington Post: Ambitious Health Care Blueprint Stresses State Flexibility, Sets Up Huge Logistical Challenge
Democratic state officials are praising the flexibility in federal rules issued Monday, a long-awaited blueprint for state health insurance markets where millions of consumers will shop starting in 2014. States have a range of options for designing and running the new markets, called exchanges. … But Republicans say the health care law still amounts to a power grab by Washington. "Once again, the Obama administration has overpromised, oversold and under-delivered," said Bob McDonnell, Virginia's GOP governor (3/13).

Los Angeles Times: White House Relaxes Key Rule In New Healthcare Law
The administration moved to ease development of state-based insurance exchanges for Americans not covered by employers. States will get more flexibility in running the exchanges and may get help setting them up (Levey, 3/12).

Modern Healthcare: Official Notes Exchange Rule's Flexibility
The final rule that outlined design requirements of state health insurance exchanges differed in some ways from the proposed rules that preceded it. The 644-page final rule outlined details of the exchanges, or insurance marketplaces, which are scheduled to launch Jan. 1, 2014, and offer insurance plan options for individuals and small businesses. 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 (Daly, 3/12).

Reuters: New Healthcare Exchange Rules Issued For States
The Obama administration on Monday released broad new operating rules for state-run health insurance exchanges, which form a key part of the 2010 federal healthcare reform law that will face landmark Supreme Court hearings in just two weeks. The long-awaited regulations, released by the Department of Health and Human Services, are intended to provide state lawmakers and officials flexibility on federal deadlines as they meet the complex task of building state and regional insurance markets before a January 1, 2014, deadline (Morgan, 3/12).

National Journal: New Health Exchange Regulations Make Room For Brokers
Brokers and other third-party administrators will be allowed to direct people to state insurance exchanges -; the marketplaces created by the 2010 health care reform law where people can buy insurance policies -; and check to see if they are qualified for tax credits under long-awaited final regulations released on Monday. That means a possible new business model for insurance brokers or any other companies looking to set up an access point to the state insurance exchanges -; something that concerns some consumer groups (McCarthy, 3/12).

CQ HealthBeat: HHS Keeps Exchange Rulemaking Moving Via Staggered Approach
The Obama administration has resorted to various tactics over the past two years to keep rulemaking moving under the health law despite the enormity of the job. On Monday it struck again, moving long-awaited final health insurance exchange regulations out the door, thanks to a staggered approach. It was a little like giving a college professor a big chunk of a mammoth final term paper to read while promising to turn in the rest before she finished reading the first part (Reichard, 3/12).

In other news related to the health law's implementation -

CQ HealthBeat: HHS Officials Pledge 'Partnership' To Launch Co-Ops
To some they may seem as babes in the woods about to be menaced by large animals. But people launching health care cooperatives with loans issued under the health law are brimming with hope and basking in the good wishes of federal officials, for now at least. In Washington on Friday for a conference sponsored by the National Alliance of State Health Cooperatives (NASHCO), the organizers of the new ventures heard expressions of admiration from government officials but also blunt advice that they face "a huge lift," in the words of Barbara Smith, associate director of the Co-op Program at Health and Human Services (Reichard, 3/12).