Federal officials are laying the groundwork for the launch of state-based health insurance exchanges in 2014, handing out millions of dollars in grants to states, designing tools to determine eligibility to buy insurance, and proposing details on how the refundable premium tax credits will work.
The Health and Human Services department announced during a teleconference Aug. 12 that it is awarding $185 million in "establishment" grants to 13 states and the District of Columbia to help them build their insurance exchanges. These grants follow planning grants awarded last year by HHS. More than half of the states have already taken some action to begin building their exchanges, according to HHS.
HHS, along with the Treasury Department, also issued three proposed rules aimed at creating a system that’s easy for consumers and small businesses to navigate. The first proposal, issued by HHS, outlines the standards and processes for consumers to enroll in a health plan and to seek financial assistance. It also explains the standards for small employers to participate in the exchange. Another proposal attempts to simplify the process for determining eligibility in Medicaid and the Children’s Health Insurance Program and coordinate these processes with the insurance exchanges, so that individuals can move from Medicaid to another health plans without losing coverage.
Finally, the Treasury Department issued a proposed regulation that explains how individuals and families can receive premium tax credits for purchasing insurance. Under the Affordable Care Act, taxpayers with incomes between 100% and 400% of the federal poverty level will be eligible for premium tax credits if they purchase insurance through the exchange for themselves or a family member. The tax credits are paid in advance to the health plan to reduce the individual’s monthly premium.