On November 25, 2020, the U.S. Departments of Health & Human Services (HHS) and Treasury released the proposed 2022 “Notice of Benefit & Payment Parameters” (NBPP), the annual rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for insurers, and the risk adjustment program. This expert perspective focuses on several provisions that have implications for state oversight of insurance markets and the state-based marketplaces. Comments on the proposed rule are due by December 30, 2020.
Federally-Facilitated Exchanges and the Continuum of State Options
Manatt Health Solutions – Deborah Bachrach and Patricia Boozang
The Affordable Care Act allows states to create their own state-based health insurance exchanges or to allow a federally facilitated exchange to operate in the state. Proposed rules from the Department of Health and Human Services (HHS) also allow a partnership model where the federal and state governments share in the execution of exchange functions. This brief, supported by the State Network and published by the National Academy for Social Insurance, explores the continuum of options for states from fully state-based to fully federally facilitated, evaluating the considerations and implications associated with each option to help states determine which model may work best for the unique needs of their residents. The authors conclude that regardless of the model chosen, success can only be achieved through intensive collaboration between individual states and HHS.