Download or read book States Establishment of Health Insurance Exchanges written by Fredrik C. Lewis and published by Novinka Books. This book was released on 2014-05-14 with total page 105 pages. Available in PDF, EPUB and Kindle. Book excerpt: A central provision of The Patient Protection and Affordable Care Act (PPACA) requires the establishment of exchanges in each state, online marketplaces through which eligible individuals and small business employers can compare and select health insurance coverage from participating health plans. Exchanges are to begin enrollment by October 1, 2013, with coverage to commence January 1, 2014. States have some flexibility with respect to exchanges by choosing to establish and operate an exchange themselves (i.e., state-based), or by ceding this authority to HHS (i.e., federally facilitated). States may also choose to enter into a partnership with HHS whereby HHS establishes the exchange and the state assists with operating various functions. According to HHS, 18 states will establish a state-based exchange, while 25 will have a federally facilitated exchange. Seven states will partner with HHS. This book examines the states' responsibilities for establishing exchanges, the actions selected states have taken, and the challenges they have encountered.

Download or read book States Establishment of Health Insurance Exchanges written by Fredrik C. Lewis and published by Nova Science Publishers. This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A central provision of The Patient Protection and Affordable Care Act (PPACA) requires the establishment of exchanges in each state, on-line marketplaces through which eligible individuals and small business employers can compare and select health insurance coverage from participating health plans. Exchanges are to begin enrolment by 1 October 2013, with coverage to commence 1 January 2014. States have some flexibility with respect to exchanges by choosing to establish and operate an exchange themselves (ie: state-based), or by ceding this authority to HHS (ie: federally facilitated). States may also choose to enter into a partnership with HHS whereby HHS establishes the exchange and the state assists with operating various functions. According to HHS, 18 states will establish a state-based exchange, while 25 will have a federally facilitated exchange. Seven states will partner with HHS. This book examines the states' responsibilities for establishing exchanges, the actions selected states have taken, and the challenges they have encountered.

Download or read book Health Insurance written by United States Government Account Office and published by Createspace Independent Publishing Platform. This book was released on 2018-01-11 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance: Seven States' Actions to Establish Exchanges Under the Patient Protection and Affordable Care Act

Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

Download or read book Health Insurance Exchanges Under the Patient Protection and Affordable Care Act ACA written by Bernadette Fernandez and published by Createspace Independent Pub. This book was released on 2012-10-20 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fundamental purpose of a health insurance exchange is to provide a structured marketplace for the sale and purchase of health insurance. The authority and responsibilities of an exchange may vary, depending on statutory or other requirements for its establishment and structure. The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) requires health insurance exchanges to be established in every state by January 1, 2014. ACA provides certain requirements for the establishment of exchanges, while leaving other choices to be made by the states. Qualified individuals and small businesses will be able to purchase private health insurance through exchanges. Issuers selling health insurance plans through an exchange will have to follow certain rules, such as meeting the private market reform requirements in ACA. While the fundamental purpose of the exchanges will be to facilitate the offer and purchase of health insurance, nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges. Moreover, ACA explicitly states that enrollment in exchanges is voluntary and no individual may be compelled to enroll in exchange coverage. Exchanges may be established either by the state itself as a “state exchange” or by the Secretary of Health and Human Services (HHS) as a “federally facilitated exchange.” All exchanges are required to carry out many of the same functions and adhere to many of the same standards, although there are important differences between the types of exchanges. States will need to declare their intentions to establish their own exchanges by no later than November 16, 2012. ACA and regulations require exchanges to carry out a number of different functions. The primary functions relate to determining eligibility and enrolling individuals in appropriate plans, plan management, consumer assistance and accountability, and financial management. ACA gives various federal agencies, primarily HHS, responsibilities relating to the general operation of exchanges. Federal agencies are generally responsible for promulgating regulations, creating criteria and systems, and awarding grants to states to help them create and implement exchanges. A state that is approved to operate its own exchange has a number of operational decisions to make, including decisions related to organizational structure (governmental agency or a nonprofit entity); types of exchanges (separate individual and Small Business Health Options Program (SHOP) exchanges, or a merged exchange); collaboration (a state may independently operate an exchange or enter into contracts with other states); service area (a state may establish one or more subsidiary exchanges in the state if each exchange serves a geographically distinct area and meets certain size requirements); contracted services (an exchange may contract with certain entities to carry out one or more responsibilities of the exchange); and governance (governing board and standards of conduct). In general, health plans offered through exchanges will provide comprehensive coverage and meet all applicable private market reforms specified in ACA. Most exchange plans will provide coverage for “essential health benefits,” at minimum; be subject to certain limits on cost-sharing, including out-of-pocket costs; and meet one of four levels of plan generosity based on actuarial value. To make exchange coverage more affordable, certain individuals will receive premium assistance in the form of federal tax credits. Moreover, some recipients of premium credits may also receive subsidies toward cost-sharing expenses.

Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Download or read book Overview of Health Insurance Exchanges written by Congressional Service and published by Createspace Independent Publishing Platform. This book was released on 2018-07-04 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces in which consumers and small businesses can shop for and purchase private health insurance coverage. In general, states must have two types of exchanges: an individual exchange and a small business health options program (SHOP) exchange. Exchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally facilitated exchange (FFE). Some states have SBE-FPs: they have SBEs but use the federal information technology platform, including the federal exchange website www.Healthcare.gov. In states with FFEs, the exchange may be operated by the federal government alone or in conjunction with the state. States may have different structures for their individual and SHOP exchanges. Consumers who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. Financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing reductions. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. The ACA generally requires that health insurance plans offered through an exchange are qualified health plans (QHPs). To be a certified as a QHP, a plan must be offered by a state-licensed issuer and must meet specified requirements, including covering the essential health benefits (EHB). QHPs sold in the individual and SHOP exchanges must comply with the same state and federal requirements that apply to QHPs and other health plans offered outside of the exchanges in the individual and small-group markets, respectively. Exchanges also may offer variations of QHPs, such as child-only or catastrophic plans, and non-QHP dental-only plans. This report provides an overview of the various components of the health insurance exchanges. It begins with summary information about how exchanges are structured and then discusses both individual and SHOP exchanges in terms of eligibility and enrollment, financial assistance for certain exchange consumers and small businesses, and enrollment assistance entities. The report also describes exchanges' role in certifying plans as qualified to be sold in their marketplaces and outlines the range of plans offered through exchanges. Finally, the report briefly addresses funding for the exchanges.

Download or read book Health Insurance Exchanges Under the Affordable Care Act written by Edward J. Volpicelli and published by Nova Science Publishers. This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fundamental purpose of a health insurance exchange is to provide a structured marketplace for the sale and purchase of health insurance. The authority and responsibilities of an exchange may vary, depending on statutory or other requirements for its establishment and structure. The Patient Protection and Affordable Care Act (ACA) requires health insurance exchanges to be established in every state by January 1, 2014. ACA provides certain requirements for the establishment of exchanges, while leaving other choices to be made by the states. This book outlines the required minimum functions of exchanges, and explains how exchanges are expected to be established and administered under ACA. The coverage offered through exchanges is discussed, as are how the exchanges will interact with selected other ACA provisions.

Download or read book Health Insurance Exchanges and the Assistance Role of Navigators written by Wallace V. Bremer and published by Nova Science Publishers. This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fundamental purpose of a health insurance exchange is to provide a structured marketplace for the sale and purchase of health insurance. The authority and responsibilities of an exchange may vary, depending on statutory or other requirements for its establishment and structure. The Patient Protection and Affordable Care Act requires health insurance exchanges to be established in every state by January 1, 2014. The ACA provides certain requirements for the establishment of exchanges, while leaving other choices to be made by the states. Qualified individuals and small businesses will be able to purchase private health insurance through exchanges. Issuers selling health insurance plans through an exchange will have to follow certain rules, such as meeting the private market reform requirements in the ACA. While the fundamental purpose of the exchanges will be to facilitate the offer and purchase of health insurance, nothing in the ACA prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges. This book outlines the required minimum functions of exchanges, and explains how exchanges are expected to be established and administered under the ACA. The coverage offered through exchanges is discussed, and the book concludes with a discussion of how exchanges will interact with selected other ACA provisions.

Download or read book Health Insurance written by Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-08-08 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Why GAO Did This Study A central provision of PPACA requires the establishment of exchanges in each state-online marketplaces through which eligible individuals and small business employers can compare and select health insurance coverage from participating health plans. Exchanges are to begin enrollment by October 1, 2013, with coverage to commence January 1, 2014. States have some flexibility with respect to exchanges by choosing to establish and operate an exchange themselves (i.e., state-based), or by ceding this authority to HHS (i.e., federally facilitated). States may also choose to enter into a partnership with HHS whereby HHS establishes the exchange and the state assists with operating various functions. According to HHS, 18 states will establish a state-based exchange, while 26 will have a federally facilitated exchange. Seven states will partner with HHS. GAO was asked to report on (1) states' responsibilities for establishing exchanges, and (2) actions selected states have taken to establish exchanges and challenges they have encountered. To do this work, GAO reviewed PPACA provisions and HHS implementing regulations and guidance. GAO also conducted semistructured interviews with state officials in the District of Columbia, Iowa, Minnesota, Nevada, New York, Oregon, and Rhode Island. For this review, GAO refers to the District of Columbia as a state. GAO selected these states based on several criteria, such as a 3-year average of states"

Download or read book Health insurance written by United States. Government Accountability Office and published by . This book was released on 2013 with total page 33 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Patient Protection and Affordable Care Act written by U.s. Government Accountability Office and published by . This book was released on 2017-08-04 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Why GAO Did This StudyThe Patient Protection and Affordable Care Act (PPACA) requires SHOPs-exchanges or marketplaces where small employers can shop for health coverage for their employees-to be established in all states. PPACA also requires similar exchanges to be established for individuals. CMS oversees the establishment of the SHOPs, approving states to operate one or establishing and operating one itself in states that will not do so. Enrollment is to begin October 2013, with coverage effective January 2014, although a key requirement related to employee choice was deferred for 1 year. GAO was asked to examine federal and state readiness to establish the SHOPs. In this report, GAO describes (1) the roles of the federal government and states in establishing SHOPs and (2) the status of actions taken and planned by the federal government and states in preparing to establish SHOPs.GAO reviewed CMS regulations and guidance on the roles of CMS and states in establishing both SHOPs and individual exchanges, as progress establishing the two exchanges is related. GAO reviewed CMS planning documents used to track the progress of key activities to be conducted by CMS to establish FF-SHOPs and FFEs. GAO also reviewed target completion dates for key activities CMS established for states and obtained updates from CMS on state progress. GAO interviewed CMS officials and relied largely on documentation from CMS-including"

Download or read book Patient Protection and Affordable Care ACT written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2018-01-11 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act: Status of Federal and State Efforts to Establish Health Insurance Exchanges for Small Businesses

Download or read book The Affordable Care Act and Health Insurance Markets written by Christine Eibner and published by Rand Corporation. This book was released on 2013-08-29 with total page 117 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this report, the authors estimate the effects of the Affordable Care Act on health insurance enrollment and premiums for ten states (Florida, Kansas, Louisiana, Minnesota, New Mexico, North Dakota, Ohio, Pennsylvania, South Carolina, and Texas) and for the nation overall, with a focus on outcomes in the nongroup and small group markets.

Download or read book Patient Protection and Affordable Care Act written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-08-04 with total page 54 pages. Available in PDF, EPUB and Kindle. Book excerpt: " The Patient Protection and Affordable Care Act required the establishment in all states of exchanges-marketplaces where eligible individuals can compare and select health insurance plans. CMS must oversee the establishment of exchanges, including approving states to operate one or establishing and operating one itself in states that will not do so. CMS will approve states to assist it in carrying out certain FFE functions. CMS will also operate an electronic data hub to provide eligibility information to the exchanges and state agencies. Enrollment begins on October 1, 2013, with coverage effective January 1, 2014. GAO was asked to examine CMS's role and preparedness to establish FFEs and the data hub. In this report, GAO describes (1) the federal government's role in establishing FFEs for operation in 2014 and state participation in that effort; and (2) the status of federal and state actions taken and planned for FFEs and the data hub. GAO reviewed regulations and guidance issued by CMS and documents indicating the activities that the federal government and states are expected to carry out for these exchanges. GAO also reviewed planning documents CMS used to track the implementation of federal and state activities, including documents describing the development and implementation of the data hub. GAO also interviewed CMS officials responsible for establishment of the exchanges. GAO relied largely on documentation provided by CMS"

Download or read book Health Insurance Exchanges written by Suzanne M. Kirchhoff and published by CreateSpace. This book was released on 2015-06-26 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 2010 Patient Protection and Affordable Care Act (ACA, P.L. 111-148) allows certain individuals and small businesses to buy qualified health insurance through state exchanges. The exchanges are not themselves insurers, but rather are special marketplaces where insurance firms may sell health policies that meet set, federal guidelines. As of July 2014, 14 states and the District of Columbia had secured HHS approval to create and run their own exchanges, 7 to enter into partnership exchanges, 29 to have federally facilitated exchanges, and two to have state-based SHOP/federally facilitated individual exchanges. An estimated 25 million individuals are expected to secure coverage through the exchanges by 2024.

Download or read book Health Insurance Exchanges written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2015 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt: