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06/12/2024
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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 states may submit both a letter of intent and an application to operate its own exchange by December 14. 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.
Nebraska is currently studying its options regarding a health insurance exchange. Its legislature introduced two bills (LB 835 and LB 838) in early 2012 to establish a health insurance exchange in the state, but both failed. Nebraska’s Department of Insurance is now leading the exchange planning process.
In 2011, Governor Dave Heineman signed a law (LB 22) that prohibits qualified health insurance plans participating in health insurance exchanges from covering abortions in Nebraska, except when a physician has verified the abortion is necessary to prevent the pregnant woman’s death.
To date, Nebraska has received a $1 million Exchange Planning grant and a $5.5 million Level One Establishment grant.
Governor Heineman declared the state-based exchange too expensive and told the federal government to build an exchange for Nebraska.
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