State insurance exchanges - South Carolina

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.

South Carolina has decided not to implement a state-based health insurance exchange. The South Carolina Health Planning Committee concluded the state cannot implement a state-based exchange as required by the Affordable Care Act (ACA) and recommended the establishment of private exchanges.

Governor Haley signed into law S 0102, which prohibits plans in a state exchange from providing abortion coverage, except in cases of rape, incest, or to avert the death of the pregnant woman.

South Carolina received a $1 million Exchange Planning grant, and Governor Haley has stated that the state will not pursue any more federal grant money.

Unless the state reverses its decision, the federal government will assume responsibility for running a health insurance exchange in South Carolina.

State

Contacts

South Carolina Healthy Connections

Regulations

Title 38, Chapter 74, Health Insurance Pool

S 0102

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