Today, the U.S. Department of Health and Human Services (HHS) issued a proposed rule that governs how states will build and run Affordable Insurance Exchanges (Exchanges). Established under the Affordable Care Act, Exchanges are state-based marketplaces where individuals and small business can purchase health insurance. If finalized, the rule sets minimum standards for Exchanges, which are set to become operational by January 1, 2014.

In a news release, HHS highlighted two key areas of guidance to states on how to structure their Exchanges:

• Setting standards for establishing Exchanges, setting up a Small Business Health Options Program, performing the basic functions of an Exchange, and certifying health plans for participation.

• Ensuring premium stability for plans and enrollees in the Exchange.

The rule proposes an Exchange approval process, including submission of an Exchange Plan and an operational readiness assessment by HHS. The rule also outlines an Exchange Plan review process similar to Medicaid and CHIP (i.e., a 90-day review period).

More information about Exchanges is available here.