State insurance exchanges - Florida

Summary of differences between federal and state regulations

The U.S. Department of Health and Human Services (HHS) must make a determination on or before January 1, 2013, that a state will in fact have an exchange in operation by 2014 and that the exchange meets the requirements of the Affordable Care Act (ACA) and HHS guidance. In a letter dated November 15, 2012, Secretary Sebelius indicated that a state may submit both a letter of intent and an application to operate its own exchange by December 14, 2012. If a state elects not to operate an exchange, or if the HHS determines that the state will not be able to have an exchange operational by 2014 that meets the law’s requirements, the ACA gives the HHS the authority to establish and operate such exchange within the state.

On July 1, 2012 Florida Governor Rick Scott announced that Florida was opting out of Medicaid expansion and state-run exchanges. Florida will implement and comply with mandatory sections of the ACA.

The Florida Agency for Health Care Administration returned a $1 million federal Exchange Planning grant that it received in 2010.

On June 2, 2011 Florida enacted a law prohibiting coverage of abortions when insurance is purchased through an exchange using state of federal funds, except in the case of rape, incest, or when the mother’s life is endangered.

State

Contacts

Florida Agency for Health Care Administration

Florida Office of Insurance Regulation

Regulations

Florida Statutes

Chapter 627 – Insurance Rates and Contracts

PART VI HEALTH INSURANCE POLICIES

627.64995 Restrictions on use of state and federal funds for state exchanges.

Part VII GROUP, BLANKET, AND FRANCHISE HEALTH INSURANCE POLICIES (ss. 627.651-627.66996)

627.6515 Out-of-state groups.

627.6699 Employee Health Care Access Act.

627.66996 Restrictions on use of state and federal funds for state exchanges.

Chapter 641 – HEALTH CARE SERVICE PROGRAMS

Part I: HEALTH MAINTENANCE ORGANIZATIONS

641.31099 Restrictions on use of state and federal funds for state exchanges.

Federal

Contacts Center for Consumer Information and Insurance Oversight (CCIIO)

U.S. Department of Health and Human Services (HHS)

Regulations

45 CFR Parts 155, 156, and 157