Federal & State Regulations | State insurance exchanges - West Virginia

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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 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.

West Virginia received a $1,000,000 State Planning Grant in September 2010. The state also received a $9,967,694 Level One Establishment Grant.

On April 5 2011, West Virginia Gov. Earl Ray Tomblin signed SB 408 establishing the West Virginia Health Benefits Exchange. This bill authorizes the establishment of an exchange within the Offices of the Insurance Commissioner as a governmental agency. The bill also requires the exchange to pursue federal funds and promulgate rules to achieve federal certification. If the ACA were to be invalidated or repealed, the exchange Board will issue recommendations to the Legislature for amendments to this article as necessary.