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PPACA: HHS Starts to Set Up Exchange System

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The U.S. Department of Health and Human Services (HHS) has unveiled a request for comments on ideas for designing the health insurance exchange system required by the Affordable Care Act.

Officials at the Office of Consumer Information and Insurance Oversight (OCIIO), a new arm of HHS, are asking for ideas about topics such as setting standards for the health plans qualified to participate in the exchange system, factors that might increase the number of plans that participate in an exchange, and how information about health insurance ought to be conveyed to consumers.

“What kinds of information are likely to be most useful to consumers as they determine whether to enroll in an exchange and which plans to select (within or outside of an exchange)?” OCIIO officials ask. “What are some best practices in conveying information to consumers relating to health insurance, plan comparisons, and eligibility for premium tax credits, or eligibility for other public health insurance programs (e.g., Medicaid)? What types of efforts could be taken to reach individuals from diverse cultural origins and those with low literacy, disabilities, and limited English proficiency?”

OCIIO officials developed the exchange system request for comments to begin implementation of Title I of the Patient Protection and Affordable Care Act (PPACA), a component of the Affordable Care Act package.

The request for comments is set to appear in the Federal Register

Aug. 3. Comments will be due Oct. 4.

HHS officials also have started offering up to $1 million in grants per state to help each state set up its exchange system. Grant applications are due Sept. 1.

States can use the grants for tasks such as assessing information technology systems, planning for consumer call centers, and “developing partnerships with community organizations to gain public input into the exchange planning process,” officials say.

The exchange system is supposed to be a vehicle for giving individuals and small groups a vehicle to get access to health insurance subsidies and standardized, vetted packages of health benefits.

States are supposed to have exchanges up and running by 2014. The federal government will offer a federal alternative for residents of states that fail to meet the 2014 exchange startup deadline.

Producer groups are starting the battle for a prominent role in the exchange system by lobbying for space on the new HHS consumer health coverage portal, at

HHS officials put up an early version of the portal July 1 and are supposed to revamp the site Oct. 1.

The office of Rep. Charlie Melancon, D-La., is rounding up lawmakers to sign a letter asking HHS officials to offer portal visitors an option to contact insurance agents and brokers.


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