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Preparing for the 2011 Legislative Session: Model Legislation on Insurance Reforms and Exchange Implementation
States are beginning to prepare for their 2011 legislative sessions. For many, this includes discussion of legislation that would authorize an exchange. Most experts are recommending that states set up the governance structure for their exchange early next year. This legislation would not need to be prescriptive as to the operations of the exchange, but it should establish a decision-making body and specify basic expectations.
To assist states with this task, the Exchanges Subgroup of the Health Insurance and Managed Care Committee of the National Association of Insurance Commissioners (NAIC) has developed model exchange legislation. This document now awaits approval by the full committee. The model language provides a template for state lawmakers, including drafting notes that outline decision points for states.
States are also encouraged to pass legislation in 2011 that enables them to enforce the insurance reform provisions of the Patient Protection and Affordable Care Act. In order to aid states in this task, the Health Insurance and Managed Care Committee has also drafted model legislation in the following areas:
- American Health Benefit Exchange Model Act
- Model Language for Prohibition on Preexisting Condition Exclusions for Individuals under the Age of 19
- Utilization Review and Benefit Determination Model Act (#73)
- Model Language for Lifetime and Annual Limits
- Model Language for Preventive Services
- Model Language for Prohibition on Rescissions of Coverage
- Model Language for Dependent coverage for Individuals to Age of 26
- Model Language for Choice of Health Care Professional
- Health Carrier Grievance Procedure Model Act (#72)