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PPACA exchanges: Who's done what?

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The Exchanges Subgroup at the National Association of Insurance Commissioners (NAIC) has developed a table that summarizes what each state has done about health insurance exchanges.

The Patient Protection and Affordable Care Act of 2010 (PPACA) calls for states to set up exchanges, or health insurance supermarkets, for their residents by Oct. 1 or else let the U.S. Department of Health and Human Services (HHS) provide exchange services for their residents.

The Exchanges Subgroup table shows when the NAIC staff verified the entry for a state, and whether a state is either setting up its own exchange or helping HHS run a “partnership” exchange.

If a state is running, or helping to run, its own exchange, rather than having HHS provide a “federally facilitated exchange,” the subgroup shows what kind of exchange structure the state has picked; describes how the exchange will be governed; and notes whether the exchange will be an “active purchase” that tries to negotiate with the exchange plans, or whether the exchange will simply be a “clearinghouse” that admits all qualified plans.

In the last column, the subgroup gives a Web link for the agency coordinating exchange activities for each state that is setting up, or helping to set up, an exchange.

For Oklahoma, for example, the subgroup simply indicates that the state has indicated that it will not be setting up an exchange.

For Oregon, the subgroup notes that the Oregon Health Insurance Exchange Corp. will be governed by a nine-member board and will operate as an active purchaser. The subgroup also gives a link to the Cover Oregon website.

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