['Employee Benefits']
['Health Plans']
02/07/2024
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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.
In May 2011, Governor Gregoire signed SB 5445 into law establishing the Washington Health Benefit Exchange, to be governed by an 11-member board. The legislation defines the exchange as a “self-sustaining public-private partnership separate and distinct from the state.” In March 2012, the Governor signed additional exchange legislation (HB 2319) removing limitations on the Board’s governing authority over the exchange.
Washington has received a $1 million federal Exchange Planning grant, a $23 million Level One Establishment grant, and a $127 million Level Two Establishment grant.
The Exchange Board, the Insurance Commissioner, and the Washington Health Care Authority are responsible for moving the exchange implementation forward.
December 14, 2012, is the deadline for Washington to submit an exchange blueprint consisting of a declaration letter signed by Governor Gregoire and an application to the U.S. Department of Health and Human Services, stating whether it intends to operate a fully state-based exchange or a state-federal partnership exchange.
State
Contacts
Washington Insurance Commissioner
Washington Health Care Authority
Regulations
Chapter 43.71 RCW – Washington health benefit exchange
Title 48 RCW – Insurance
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