PPACA: Launching of Healthcare Exchanges Depends on Supreme Court

In the white paper, CCIIO said, “… based on available data, it appears that medical costs are not increasing at a faster rate than they were in December 2010, when the proposed regulation was published.”

The proposed white paper added, “This would appear to argue against any increase in the threshold for reviewing rate increases.  The process described below would provide an opportunity for States to present evidence of unique conditions that would justify a threshold higher than 10%.  However, HHS would be more inclined to grant a request from a State that the threshold be lower than 10%.”

Larsen said that HHS reviewed 12 proposed rate increases in states where the governments declined to get involved, and found that 6 were unreasonable increases and 6 were not.

Larsen also said that HHS had completed reviews of 18 state requests for exemptions or exceptions on the medical loss ratio formula, rejecting 11, adjusting six and fully approving Maine’s request.

In his comments on exchanges, Larsen said that, obviously pending Supreme Court approval of the law, “every single state will have an exchange in operation as of Jan. 2014, and they will be similar.”

He and an aide acknowledged that some states will add their “own innovations,” but every consumer will have access to an exchange.”

He said market conduct rules will be released “relatively soon,” and that other rules in the works, including the summary of benefits proposal, are being worked on.

He said the agency has issued contracts for site development for the federal exchanges, as well as creating the data services “hub” that will be crucial as the single point of entry for federal exchanges.

“We are deep in development of the exchanges; there is tons of work going on,” Larsen said.