Exchange Federal-State Partnership
States have options about how much responsibility to take on in running health insurance exchanges. States may undertake some functions while delegating others to the federal government.
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Illinois
We are working with UIC School of Public Health on the training of In Person Counselors in Illinois. I'm wondering if any other federal state partnership exchanges have developed their training programs yet? Thanks!
Illinois
With all the budget issues at the state and at the federal level, I was wondering how funding will be allocated. I understand monies from the PPACA fees and taxes will be used but has it been determined which option ( such as partnership, federal) would offer the best coverage or benefit, or most costly overall?
District of Columbia
Hi Lisa- Both partnership and federal (FFE) exchanges will use federal eligibility and enrollment services and will have a 3.5% user fee. Before 2015, both partnership and FFE states can apply for and use Level 1 Establishment grant funding to help fund the state's activities but after that it is unclear if there will be further funding opportunities or if it will fall to the state to fund their activities.
In terms of benefits, plans in all exchanges will have to offer at least the essential health benefits package (EHB), including benefits specified by the ACA. EHB benchmark plans may vary slightly by state, but they must cover the 10 areas listed in the ACA and the EHB package is not dependent on the state's exchange model. For more on EHB you can read here:http://www.statereforum.org/weekly-insight/states-take-a-first-step-on-p... and see our chart of what states have chosen here: http://statereforum.org/analyses/state-progress-on-essential-health-bene...
District of Columbia
On January 3, 2013, HHS released additional information on the partnership exchange. The guidance is attached.
District of Columbia
State Refor(u)m community: how will this guidance shape your state's role in exchange policies and operations, whether you're a partnership state, or strictly an FFE state? Share your ideas here, using the "reply" button above.
District of Columbia
On November 14, 2012, Delaware Gov. Markell submitted a letter officially declaring the state as participating in a partnership exchange. The exchange was conditionally approved on December 20, 2012
District of Columbia
On December 14, 2012, IA Gov. Terry Branstad submitted a letter to HHS reversing his previous intention to create a state-based exchange and to instead set up a partnership exchange.
District of Columbia
West Virginia has tentatively decided to pursue a partnership exchange.
District of Columbia
As part of the State Health Reform Assistance Network, Manatt Health Solutions released a high level summary of tasks for states pursuing the partnership model.
Ohio
Does anyone know where to find out how the partnerships will operate administratively? Are they merely sponsored by the feds while the logistics will be set by each state?
District of Columbia
Hello Craig. Thank you for your question.
Ultimately, a partnership exchange will be a form of the federally-facilitated exchange (FFE) where administrative authority resides with the FFE. Under this model, the state will have the option to run the plan management functions, in-person consumer assistance functions or both, but the FFE must approve states to perform these functions. Plan management will include the development of certification, recertification and decertification processes within parameters set by the FFE, as well as data collection and issuer accreditation. Consumer assistance functions include supporting and administering the navigator program and providing other in person assistance. States are responsible for designating the agency that will carry out partnership functions. The FFE will be responsible for the more centralized functions of the partnership, including the call center and web site. Click here for more information on these responsibilities.
CCIIO has indicated that it intends to release further guidance on the FFE, which may shed more light on the administrative operations of a partnership exchange.
District of Columbia
NC Governor Bev Perdue announced November 15, 2012, that North Carolina would pursue a partnership exchange.
District of Columbia
The National Association of Insurance Commissioners Health Care Reform Regulatory Alternatives Working Group—a group of commissioners from states that have decided not to create a state exchange—recently released a list of questions for the federal government about the federal exchange, partnership exchange and related issues.
District of Columbia
On October 16, 2012, Illinois Gov. Pat Quinn submitted a letter to CCIIO indicating that Illinois will participate in a partnership exchange. The state will pursue both plan management and consumer assistance functions.
District of Columbia
This letter from Pennsylvania's Insurance Commissioner includes 26 questions to HHS on a range of topics, including: FFE Partnership Exchange, MAGI and the federal data hub.
Michigan
Does anyone know what functions the State of Michigan is choosing to assume under the partnership model, i.e., is it the Plan Management route or the Consumer Assistance "only" route?
District of Columbia
Hi Christine- We have not heard which partnership functions Michigan has chosen- I don't think they've announced that publicly yet. As soon as we do hear, we'll be sure to post an update here. If other users have more information, please feel free to post below.
Florida
Regarding the guidance--it is unclear if the FFE would be a seperate "Entity" much like a state HIX would be, or if there is one Federal HIX. We question this, because from a carrier perspective we need to be clear on how many "Connections" we will need to make. If a carrier is in 10 states, 5 are state HIX, 2 are the partnership model and 3 are defaulting to Federal, it is the assumption that we would have 8 connectors based on the plural terms used in the guidance--is this a correct thought?
District of Columbia
Jennifer, This is an interesting question. The guidance on federally-facilitated exchanges(FFEs) alludes to the establishment of more than one FFE, but it is unclear if there will be an individual FFE in each state that decides not to establish its own exchange. The guidance describes how each FFE will have flexibility and discretion in designing processes and procedures that reflect local market dynamics. This makes it seem as if each state will need its own FFE.
The guidance also states that HHS is in the process of developing a unified administrative framework that can support all FFEs and address a wide range of state needs. Additionally, one of the guiding principles for establishing the FFEs is that HHS will utilize existing state policies, capabilities, and infrastructure to assist in implementing the FFE. This language implies that various FFEs will be established due to the range of needs and capacities of various states.
As far as plan management, the guidance indicates that HHS will certify QHPs and enter into agreements with them. An FFE will be responsible for QHP issuer account management, QHP oversight, and recertification. HHS also plans to provide technical assistance and support to issuers on an ongoing basis following QHP certification through designated account managers that will serve as the issuer’s point of contact and will assist issuers in navigating FFE and State requirements.
We will continue to monitor and analyze future guidance related to this issue. Hope this helps.
District of Columbia
On May 16, 2012, the federal government released guidance for states on the federally-facilitated exchange and the federal-state partnership model. You can find the guidance on State Refor(u)m at
http://www.statereforum.org/sites/default/files/ffe_guidance_final_versi....