While the Republicans were off crusading against contraception the Department of Health and Human Services announced final standards for how the state health insurance exchanges are designed to operate under the Affordable Care Act.
Early estimates indicate that 32 million Americans are expected to gain access to health insurance under the Affordable Care Act, and a vast majority of them will do so through the state exchange. The final standards suggest the White House is taking a flexible approach in working with states in designing the exchanges. States will get to decide who runs the new market exchanges and which insurance companies get to participate. And should the state not have the capability to oversee every aspect of managing these exchanges, some functions can be outsourced back to the federal government.
It’s a structure that should address concerns of a “one-size-fits-all” approach in state insurance market regulation and one that allows insurance companies plenty of flexibility in designing products for differing marketplaces. Consumers and small businesses should be able to easily compare and purchase insurance coverage with the federal government gap-filling only as needed.
But to make sure that there is fairness to all citizens across the states the federal government will still determine if what each state proposes meets general, minimal standards. So while the new marketplaces launch on January 1, 2014 HHS will spend the year prior to launch certifying those exchanges that are and are not able to meet these federal minimum standards. Those standards includes things like allowing consumers to easily compare plans and have an enrollment mechanism for both private insurance and Medicaid.
Before states can go ahead with their exchanges they must submit for approval an “Exchange blueprint”. If a state has not made significant progress toward those benchmarks in the year then the federal government will step in and do the job the state can’t seem to accomplish.
Republican governors will have their work cut out for them arguing why this kind of federal-state cooperation is not helpful or necessary, and the Obama administration will need to make sure consumers are actually able to get the kind of service the law envisions. In the meantime though as the political battle over health care reform wages on in the judiciary expanded health insurance coverage is coming. And it’s about time.
Photo from Mike Licht, NotionsCapital.com via flickr.