The Department of Health and Human Services has issued a proposed rule setting minimum standards for Web-based state insurance exchanges, mandated under the Affordable Care Act, to provide one-stop shopping of health coverage for individuals and small businesses.

Under the reform law, states must notify HHS by 2013 of their intent to build an exchange and to have it operational in 2014. The federal government will develop an exchange in any state that refuses to do so. So far, 49 states and four territories have accepted federal planning grants for the initiatives, to be called Affordable Insurance Exchanges.

The proposed rule is available now and will be published July 15 in the Federal Register. The rule establishes requirements for states to establish and operate an exchange, defines minimum requirements for insurers to participate in an exchange and offer qualified health plans, and provider standards for small businesses employers to participate.

"The intent of this proposed rule is to afford States substantial discretion in the design and operation of an Exchange," according to the rule. "Greater standardization is proposed where required by the statute or where there are compelling practical, efficiency or consumer protection reasons. This proposed rule does not address all of the Exchange provisions in the Affordable Care Act; additional guidance on the establishment and operation of Exchanges will be provided in forthcoming proposed rules."


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