Click HERE for more information on exchanges.
Earlier this summer, Dialysis Patient Citizens (DPC) submitted a letter to HHS urging lawmakers to ensure that dialysis services are considered an essential health benefit in the new exchanges, reflective of the current standard of coverage, meaning that individuals who have or develop end stage renal disease (ESRD) are not subject to "de facto" annual/lifetime limits or other coverage limitations that would set a defined number of treatments or period of time.
The health insurance exchanges will start in 2014 and are state-run private health insurance markets created by the Affordable Care Act where consumers can shop and compare health insurance. States can use federal grants for a number of different activities including conducting background research, consulting with stakeholders, making legislative and regulatory changes, governing the exchange, establishing information technology systems, conducting financial management and performing oversight and ensuring program integrity.
“Exchanges offer Americans competition, choice, and clout,” said HHS Secretary Kathleen Sebelius. “Insurance companies will compete for business on a transparent, level playing field, driving down costs; and Exchanges will give individuals and small businesses the same purchasing power as big businesses and a choice of plans to fit their needs.”
HHS’ recent announcement is designed to help support and guide states in their efforts to implement Exchanges. HHS proposed new rules offering states guidance and options on how to structure their Exchanges in two areas:
- Setting standards for establishing Exchanges, setting up a Small Business Health Options Program (SHOP), performing the basic functions of an Exchange, and certifying health plans for participation in the Exchange, and;
- Ensuring premium stability for plans and enrollees in the Exchange, especially in the early years as new people come in to Exchanges to shop for health insurance.
These proposed rules set minimum standards for Exchanges, give states the information they need to design Exchanges that best fit their unique insurance markets, and are consistent with steps states have already taken to move forward with exchanges.
Forty-nine states, the District of Columbia and four territories accepted grants to help plan and operate exchanges. In addition, over half of all states are taking additional action beyond receiving a planning grant such as passing legislation or taking Administrative action to begin building exchanges. States will continue to implement exchanges on different schedules through 2014.
