With regard to the Exchange Eligibility and Employer Standards rule, the regulation outlines processes for enrolling qualified health plans and insurance affordability programs through the exchange that HHS said is intended to be easy, fast and coordinated so individuals generally will be able to receive an eligibility determination and enroll in the same session.
“If you look at this from a consumer lens, we don't anticipate that individuals, families, small business owners will have to decide which door to go through,” HHS Secretary Kathleen Sebelius said in a conference call with reporters on Friday. “It's a common portal.”
The premium tax credit (PDF) is intended to make it easier for middle-class Americans to buy health insurance, and is generally available to individuals and families with incomes between 100% and 400% of the federal poverty level (ranging from $22,350-$89,400 for a family of four in 2011). Emily McMahon, deputy assistant secretary for tax policy at the Treasury Department told reporters during the call that the estimated average credit is about $5,000 per year, and the Congressional Budget Office has estimated about 20 million people will be eligible for it after it is fully phased in.
And the Medicaid and CHIP proposed rule outlines steps that seek to expand access to coverage with federal support while simplifying the Medicaid and CHIP programs. One such proposal calls for a new Medicaid coverage group that will cover adults with incomes up to 133% of the federal poverty level. Another proposes new federal matching rates that will provide 100% federal funding for newly eligible individuals for three years (2014-2016) that is gradually reduced to 90%—where it will stay permanently—in 2020.
Meanwhile, Sebelius sent a letter to state governors that highlights a partnership that will allow states to work with HHS as they establish exchanges, and also asks for comments on how that partnership can build on the flexibility that states have in a design that works for them.
The proposed rules—which include a 75-day comment period—will be published in the Federal Register on Aug. 17. HHS and Treasury will also hold forums on these issues in Atlanta, Chicago, New York, Portland, Ore.; and Sacramento, Calif.