State insurance exchanges - Texas

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.

In July 2012, Governor Perry announced that Texas would not establish a state-based exchange. The Texas Department of Insurance received a $1 million Exchange Planning grant but has since returned $900,000 to the federal government.

The federal government will assume responsibility for running a health insurance exchange in Texas, unless the state reverses its decision.

State

Contacts

Texas Department of Insurance

Regulations

Title 8 Insurance Code, Subtitle M, Chapter 1695 and Chapter 1696; Federal Patient Protection And Affordable Care Act

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