July 13, 2011

Sebelius Unveils Rules For State Health Exchanges

BY Dr. Keith J. Kaplan

Print media provided extensive coverage of the Obama Administration's announcement on Monday of new rules for the state health exchanges mandated by the healthcare law. Most sources agree that in crafting the regulations, the Administration sought to provide states with much flexibility. Coverage was generally positive, although some sources said that the rules may lead to more questions.

The New York Times (7/12, A12, Pear, Subscription Publication) reports, "In a big step to carry out the new health care law, the Obama administration unveiled standards on Monday for insurance marketplaces that will allow individuals, families and small businesses in every state to shop for insurance, compare prices and benefits and buy coverage." HHS Secretary Kathleen Sebelius "said the insurance exchanges, the centerpiece of the new law, 'will offer Americans competition, choice and clout.'"

The Los Angeles Times (7/12, Levey) reports, "These state-based exchanges are intended to make buying a health plan comparable to shopping the Internet for an airline ticket or a hotel room. And by 2019, they are expected to serve as the main insurance resource for an estimated 24 million Americans who don't get their health insurance from their employer, according to the nonpartisan Congressional Budget Office." Small businesses "with fewer than 100 employees also will be able to use the exchanges, which will have to offer plans with a minimum level of coverage." In addition, "no plans will be able to deny coverage to people with pre-existing conditions." 

The Wall Street Journal (7/12, Mathews, Subscription Publication) reports that health exchanges are crucial to the healthcare law, and the new regulations aim to provide states with flexibility in implementing them. Yet, to date, only 12 states have passed legislation to create them. The Journal says that because states have so much leeway in these new regulations, they could face struggles about how much authority exchange regulators should have.

The Hill (7/12, Baker) reports in its "Healthwatch" blog, "The proposed rule leaves most key decisions up to the states, though it sets some minimum standards for every exchange — including limits on the role of insurance companies and agents."

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