HHS, IRS Issue Proposed Rules on Health Exchange Enrollment, Subsidies, Credits - August 17, 2011

The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) on Aug. 12 issued joint rules related to the implementation of health insurance exchanges, as set forth under the Affordable Care Act. The HHS proposed rule sets forth procedures for enrollment of individuals in online insurance exchanges, and establishes procedures and rules for participation in the Small Business Health Options Program (SHOP), which is geared toward small employers and their workers. The Centers for Medicare & Medicaid Services also issued a companion proposed rule (described in more detail in this week’s article “CMS Issues Proposed Rule on Medicaid Eligibility Determination”) on eligibility determinations for exchange enrollees. Finally, the IRS issued a proposed rule to set forth the premium tax credits for exchange enrollees with incomes between 100 and 400 percent of the federal poverty level. Comments on all three proposed rules will be due 75 days after their publication in the Federal Register, which is slated for Aug. 17. Following on the heels of these proposed rules, HHS announced it is awarding 13 states and the District of Columbia a total of $185 million to help them develop exchanges.