Insurance Exchanges

This paper focuses on states’ roles in implementation of FFEs. It provides an overview of recent regulations issued by CCIIO that describe the possible roles both for states and the federal government in the FFEs. It then provides in-depth descriptions of each of the specific FFE options as implemented in three states—Alabama, Michigan, and Virginia—with an eye to each state’s role in developing mechanisms to carry out their new responsibilities and progress in creating relationships with the federal government in order to ensure successful implementation of the three types of federally facilitated exchanges.

The ACA and the Department of Health and Human Services (HHS) regulations require states and American Health Benefit Exchanges (exchanges) to carry out a number of key functions, for which state responsibilities vary by exchange type. Despite some challenges, the seven selected states in GAO’s review reported they have taken actions to create exchanges, which they expect will be ready for enrollment by the deadline of October 1, 2013

This final rule issued by HHS amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents. It also confirms that implementation of employee choice in the federal SHOP exchange will be delayed until 2015. 

On March 20, 2013, Governor Mark Dayton signed exchange legislation into law. The legislation establishes the Minnesota exchange as an entity within the executive branch governed by a seven-member board.