The three proposed rules released by HHS and Treasury focus on the following:

Easy, simple access to coverage for consumers and small businesses. New rules will make it easy for consumers to enroll in high-quality health plans and get help paying for health coverage through premium tax credits and cost sharing reductions. Small employers participating in the Small Business Health Options Program will be able to offer their employees a choice of health plans and cut their costs with new tax credits.
Health insurance premium tax credit. Individuals and families will receive premium tax credits to help defray insurance costs, increasing access to health coverage for middle class American families. The tax credit will be available to those families with incomes between 100 percent and 400 percent of the poverty level ($22,350 – $89,400 for a family of four in 2011). The CBO estimates the average credit will be $5,000 a year once the credit is fully phased in.
Medicaid. The rule proposes a new Medicaid coverage group that will cover adults with incomes up to 133 percent of the FPL; new federal matching rates that will provide 100 percent federal funding for newly eligible individuals for three years, gradually reduced to 90 percent in 2020; simplifying eligibility by relying on modified adjusted gross income and creating only four categories of eligibles; and creating better coordination across the exchanges, Medicaid, and CHIP.

In her letter to governors, Sebelius lays out a partnership that will allow states to work with HHS to set up exchanges while making more efficient use of shared resources. The letter asks for comments from states on how the partnership model can build on the flexibility states have when designing an exchange that works for them.

Instant Insights /

HHS proposes rules on tax credits, health exchanges

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