HHS offers framework to establish Affordable Insurance Exchanges

WASHINGTON — The U.S. Department of Health and Human Services on Monday proposed a framework to assist states in building Affordable Insurance Exchanges, state-based competitive marketplaces where individuals and small businesses will be able to purchase affordable private health insurance.

“Exchanges offer Americans competition, choice and clout,” stated HHS Secretary Kathleen Sebelius. “Insurance companies will compete for business on a transparent, level playing field, driving down costs; and Exchanges will give individuals and small businesses the same purchasing power as big businesses and a choice of plans to fit their needs.”

The National Community Pharmacists Association issued a statement of initial support of the HHS document, specifically citing the need to create a transparent, level playing field with regard to pharmacy benefit managers. “Community pharmacists applaud the department for including in the proposed rule PBM transparency language, a bipartisan provision of the [Patient Protection and] Affordable Care Act,” stated NCPA EVP and CEO Douglas Hoey. “With this step, the administration is also reaffirming its support for PBM transparency in the exchanges by including an implementation pathway in the rule.”

Beginning in 2014, Exchanges will make it easy for individuals and small businesses to compare health plans, find out if they are eligible for tax credits for private insurance or health programs like the Children’s Health Insurance Program, and enroll in a health plan that meets their needs, according to HHS.

HHS is accepting public comment on the proposed rules over the next 75 days to learn from states, consumers and other stakeholders how the rules can be improved. HHS will modify these proposals based on feedback from the American people. To facilitate that public comment process, HHS will convene a series of regional listening sessions and meetings.

For more information on Exchanges, including fact sheets, visit Healthcare.gov/exchanges.