The Affordable Care Act (ACA) stipulates that by 2014, each state will have an “exchange,” a health insurance marketplace for individuals and small businesses. Exchanges should provide many currently uninsured and underinsured Americans with an affordable way to obtain comprehensive health coverage. According to the ACA, individuals can purchase coverage through their state exchange if their household income exceeds the maximum for Medicaid eligibility, but is less than 400 percent of the federal poverty level. Federal subsidies will help defray the premium costs for lower- and middle income individuals and families. Businesses with up to 100 employees are also eligible to purchase coverage through the exchanges. Using federal guidelines, each state will develop and operate its own exchange, or join a regional exchange. If a state does not implement its own exchange, the Secretary of Health and Human Services (HHS) will set one up for that state.
The Centers for Medicare & Medicaid Services (CMS) recently requested public comment on how state health exchanges – and the health plans offered within them – should operate. NASW argued persuasively for consumer protections in the exchanges – and for the inclusion of professional social workers as providers in all health plans that are offered through the exchanges. Read NASW’s comments.
We encourage you to review the proposed rules [http://www.regulations.gov/#!documentDetail;D=HHS-OS-2011-0020-0001] and submit your own comments.