Insurers will know by Nov. 16 how states in which they operate will choose to run their health insurance exchanges--establish their own exchange, defer to the federal exchange or choose to only perform some services. That's the deadline that the Department of Health & Human Services set in new guidance issued Wednesday.
If states can't or won't operate their own exchanges, insurers can sell plans through a federally facilitated exchange, which HHS will administer. HHS said in the guidance that it "will seek to harmonize … policies with existing state programs and laws wherever possible."
Those insurers operating in states with the federally facilitated exchange will only have to meet basic requirements to sell plans because HHS said it will create an open marketplace exchange. However, HHS officials said they may explore other options in the future, reported Kaiser Health News.
HHS also will analyze all plans to ensure benefit designs don't discriminate and will review new rates and increases for reasonableness, according to the Health Affairs blog.
The amount of progress that states have made toward creating exchanges is varied, as many states await the U.S. Supreme Court's ruling next month. Thus far, 34 states and the District of Columbia have accepted federal grant money to help establish an insurance exchange. But only 15 states have actually taken steps to establish exchanges through legislation or executive order, Reuters reported.
For states operating their own exchanges, HHS provided a blueprint guidance document, explaining the steps they must take toward that goal.