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Draft Blueprint for Approval of Affordable State-based and State Partnership Insurance Exchanges

The Affordable Care Act establishes Affordable Insurance Exchanges (Exchanges) to provide individuals and small business employees with access to health insurance coverage beginning January 1, 2014. 1 An Exchange is an entity that both facilitates the purchase of Qualified Health Plans (QHP) by qualified individuals and provides for the establishment of a Small Business Health Options Program (SHOP), consistent with Affordable Care Act 1311(b) and 45 CFR 155.20. Exchanges will provide competitive marketplaces for individuals and small employers to directly compare and purchase private health insurance options on the basis of price, quality, and other factors. Exchanges are. | Draft Blueprint for Approval of Affordable State-based and State Partnership Insurance Exchanges Introduction The Affordable Care Act establishes Affordable Insurance Exchanges Exchanges to provide individuals and small business employees with access to health insurance coverage beginning January 1 2014.1 An Exchange is an entity that both facilitates the purchase of Qualified Health Plans QHP by qualified individuals and provides for the establishment of a Small Business Health Options Program SHOP consistent with Affordable Care Act 1311 b and 45 CFR 155.20. Exchanges will provide competitive marketplaces for individuals and small employers to directly compare and purchase private health insurance options on the basis of price quality and other factors. Exchanges are integral to the Affordable Care Act s goal of prohibiting discrimination against people with pre-existing conditions and insuring all Americans. The Affordable Care Act provides States with significant flexibility in the design and operation of their Exchange to best meet the unique needs of their citizens and their marketplace. States can choose to operate as a State-based Exchange or the Secretary of the Department of Health Human Services HHS will establish and operate a Federally-facilitated Exchange in any State that does not elect to operate a State-based Exchange. In a Federally-facilitated Exchange the State may pursue a State Partnership Exchange where a State may administer and operate Exchange activities associated with plan management and or consumer assistance. States that elect to participate in a State Partnership Exchange will administer these functions in both the individual and the small group market. Regulations implementing the Affordable Care Act require HHS to Approve or Conditionally Approve State-based Exchanges no later than January 1 2013 for operation in 2014. In addition the Affordable Care Act 1321 c 1 B ii I directs the Secretary to make a determination regarding whether