Health Reform Update: Guidelines for Health Insurance Exchanges Issued

On Monday, March 12 the Department of Health and Human Services (HHS) issued guidelines for Health Insurance Exchanges. The exchanges are seen as a key element in the new health law, offering one-stop shops for individuals and small businesses looking to purchase health insurance. They are also intended to help determine applicants’ eligibility for programs such as Medicaid, and for federal subsidies to help them purchase insurance. Highlights of the recently issued guidelines include:

• The Federal Government is to approve the State Plan for their exchange by January 1, 2013. They will offer conditional approval if plans are far along.

• The State Exchanges themselves will determine the number and type of health plans offered to consumers within “broad standards” set by the Federal Government.

• Consumers will be able to apply online themselves for coverage in State exchanges.

• State Exchanges will be able to select federally approved Medicaid coordination methods.

• Exchanges will be able to use “Navigators” to help educate consumers and small businesses about the new system. 

The exchanges are to be up and running by January 1, 2014 or the federal government can step in and run them. As you know, the state of Georgia joined the lawsuit that is now going before the Supreme Court (to be decided later this summer). The state of Georgia is reported to be studying options for implementing the new law should it survive.   

What to watch for:

• The Supreme Court ruling later this summer and impact on the new law.

• Coverage mandates from HHS.

• Impact on your insurance premiums.

• If the Supreme Court upholds the law, plans for our State Insurance exchanges.

Questions for Cumming Patch Readers:  

• How is Health Reform impacting you or your
  business? 

• What plans are you making?  What plans are delayed?

Editor's Note: is a health, long-term care and life insurance professional, and blogger for Cumming Patch.