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PPACA: HHS Offers a la Carte Exchange Services

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The U.S. Department of Health and Human Services (HHS) says it wants to let states perform the health insurance exchange-related functions they really want to perform and have HHS handle the other functions.

Officials from the Center for Consumer Information and Insurance Oversight (CCIIO), an HHS arm that is overseeing HHS implementation of many components of the Patient Protection and Affordable Care Act of 2010 (PPACA), talked about the proposed federal-state partnership program today at a meeting for regulators from states using HHS grants to explore the idea of setting up health insurance distribution exchanges.

If PPACA takes effect as written and works as drafters expect, the exchanges are supposed to help individuals and small groups use a new system of tax-credit subsidies to buy private health coverage by 2014. HHS has said that a state can choose to be home to one exchange or several exchanges, or let HHS take care of providing exchange services for its residents.

A state also will be able to decide which insurers can participate in an exchange and, to some extent, which products can be sold through an exchange.

The new exchange partnership model should make the program even more flexible, officials say.

A state will be able to choose whether to handle plan management functions, consumer assistance functions, or both plan management and consumer asssistance functions, officials say.

If, for example, a state chooses to handle plan management functions, the state will get to help tailor health plan choices for its exchange, or exchanges. The state would be responsible for collecting and analyzing plan information, monitoring plans and overseeing plans.

If a state chooses to perform the exchange consumer assistance functions, it would get to manage call centers, consumer education, consumer guidance, enrollment and written correspondence tasks, officials say.

“HHS is committed to providing states the tools and resources to successfully establish and operate exchanges that work best for consumers in their state,” officials say.

Comments on the exchange partnership program proposal are due Sept. 28.

Other health insurance exchange coverage from National Underwriter Life & Health: