HHS finalizes more Obamacare policies
President Barack Obama signed the health reform overhaul in 2010.
August 28th, 2013
08:08 PM ET
12 months ago

HHS finalizes more Obamacare policies

Washington (CNN) - As part of its continued effort to solidify Affordable Care Act regulations before insurance exchanges open on October 1, the Department of Health and Human Services finalized a new rule on Wednesday clarifying how a number of issues will be handled in the new marketplaces.

"The overarching goal is to safeguard federal funds and to protect consumers by ensuring that issuers, marketplaces, and other entities comply with federal standards meant to ensure consumers have access to quality, affordable health insurance," the department said in a press release.

One issue addressed by HHS is the appeals process for Americans who feel they should qualify for coverage or federal support under the individual insurance exchange but have been deemed ineligible by the government. In its release, HHS sketched out a "federally managed appeals process" where individuals will first go through a preliminary review and receive what the department is calling an "informal resolution." If the consumer is satisfied with the outcome, that decision would be viewed as final, but if not they may request a more formal hearing.

Consumers in state-based marketplaces may first be subject to a state-specific appeals process, but can ultimately appeal to the federal government if they're unhappy with the state's decision.

Wednesday's release also outlines a separate appeals process for employers looking to appeal the government's assessment of the insurance plans they currently offer. Under the Affordable Care Act, all plans must meet federal standards for "minimum essential coverage." If the government determines that plans offered by a company don't meet those standards, under the new rules the employer may appeal that determination through either a state-run or federal process.

HHS also finalized a policy pertaining to oversight and privacy protection. While state insurance regulators will continue to provide primary oversight, the new rules allow HHS to monitor companies that offer plans on the new exchanges, in addition to the exchanges themselves, to make sure they're in compliance with federal standards. In order to be eligible to offer plans on the exchanges, the new rule also dictates that insurers must accept multiple forms of payment, including paper checks, cashier's checks, money orders, electronic transfers and prepaid debit cards, and according to HHS, they must "present all payment method options equally."

The government also released a final decision that would allow states that have chosen to default to a federally run individual insurance exchange to nonetheless set up a state-run exchange for businesses, called a Small Business Health Options Program. If the state can assure the government that its small-business exchange is up to federal standards, the rules released Wednesday say they can begin operating in 2014.


Filed under: Health care • HHS • Kathleen Sebelius
soundoff (14 Responses)
  1. boungiorno

    we can all hope

    August 28, 2013 08:46 pm at 8:46 pm |
  2. GurgyL

    This health care law is the law. No more bickering by GOP thugs. Period. Put more PAs, NPs in hospital to cut costs.

    August 28, 2013 09:15 pm at 9:15 pm |
  3. Mike Texoma

    The effort to defund Obamacare is a loser. While the nation seems divided over whether it is a good thing or not, a clear majority do not want it defunded. They want it, and government in general, to work for them. They want government to work for ordinary people, not for extremists and idealogues. They do not want the government shut down – they want it to do something reasonable for them with reasonable efficiency. So, if Obamacare is not a good thing for ordinary people they want it fixed.

    August 28, 2013 09:54 pm at 9:54 pm |
  4. Kman

    What a bunch of gobbley-goop, feel-good crap. Seems that at that a wave of a wind, the HHS has supreme control over a lot of souls. Wow. Great Britian-like waiting lines, here we come !

    August 28, 2013 09:59 pm at 9:59 pm |
  5. Eddie Fonseca

    Maurice White of the band of Earth and Fire who has toured our great land and the world and sold out many concerts with his songs, when he became ill with MS he had to turn to this nation's great healthcare system for treatment of this dreadful diease which affect's alot of Americans. Just like Luther Vandross who was the best soul singer of our times, he could melt any woman's heart across America and the world but the terrible diease of Diabetes took this great singer of our times. So what do these two people have in common they were both average and American but they needed help from our healthcare system, just like all Americans we need a free healthcare system which is not based on profit or insurance company's not paying for any our treatment due to health restictions. As American who has traveled to places such as Canada and Europe, their citzens don't need to worry about paying for their healthcare because their goverment takes care of the bills or works a payment option for the sick people who don't have the cash upfront. Obama is right to have a healthcare system which is unversial for all Americans and small bussinse owners who can have a health care plan for their employees, which in turn will burden average hardworking Americans with big health care bills like in the day of the Geroge Bush era and who want's days like that again. As Americans we need be asking ourselves some tough questions if our son or daughter was sick would we not want a healthcare system which could that bill and see them happy and healthy for years to come.

    August 28, 2013 10:45 pm at 10:45 pm |
  6. pete veslocki

    Exactly how long does this appeals process take?
    While people are unable to pay the premiums in question?
    Facing fines?

    And what happens during that time when they get sick and need mefical attention? Who pays for that?

    What do you do about the people who die during the review process?

    And don't have any health insurance?

    August 28, 2013 11:01 pm at 11:01 pm |
  7. ED1

    Wish this could be erased but looks like our stupid Senators can't see what this will cause to our people.

    Looks like we are living proof that we have a Dictator running this Country when he forces people buy insurance they don,t want or face fines and force employers to provide health or face fines.

    Thanks for nothing and goodbye America and the freedom we fought for all for nothing and if you don't think your stupid too.

    August 28, 2013 11:33 pm at 11:33 pm |
  8. nobama

    The sky is falling! Get your tinfoil hats! Limbaugh, gohmert, Palin, cantor, boner, fauxnews , what must we do? Let's all circle jerk to a picture of Tim tebow and pretend he us our lord and savior, jesus

    August 29, 2013 04:40 am at 4:40 am |
  9. Rob

    Watch. Like everything else under Obama, this will be all messed up and cost us what little we have left

    August 29, 2013 05:46 am at 5:46 am |
  10. Marie MD

    Onward and forward.
    Even red governors are trying to figure out a way to participate under the table.
    Love it!

    August 29, 2013 06:15 am at 6:15 am |
  11. TomInRochNY

    So, when will the right wing chant of "Health care takeover!" begin? Oh, they already have? Never mind.

    August 29, 2013 06:49 am at 6:49 am |
  12. king

    big companies that use to monipulize health insurance are srtoking the fire under the repubs to kill obamacare because new insurance companies will be popping up out of the wood work to compete with these larger companies and force prices down. this cannot happen, so the step to kill obamacare is being pushed through with their segregate repubs to stop this competition from smaller up and coming companies that will drive premiums down and break up their monopolies, this must be stopped at any cost.

    August 29, 2013 07:03 am at 7:03 am |
  13. Name willard

    Keep out of obamacare

    August 29, 2013 07:14 am at 7:14 am |
  14. Dixie

    This whole law is a mess. It is not ready and should not be put into effect till all the bugs are worked out.

    August 29, 2013 07:35 am at 7:35 am |